Diagnosis and management of dementia in primary care in Black Asian and Minority Ethnic (BAME) groups: an exploratory study
Award Number
PB-PG-0416-20019Programme
Research for Patient BenefitStatus / Stage
CompletedDates
2 September 2017 -31 December 2018
Duration (calculated)
01 years 03 monthsFunder(s)
NIHRFunding Amount
£124,501.00Funder/Grant study page
NIHRContracted Centre
*NHS Leicester City CCGPrincipal Investigator
Professor Andrew WilsonPI ORCID
0000-0002-9814-5966WHO Catergories
Models across the continuum of careRisk reduction intervention
Disease Type
Dementia (Unspecified)CPEC Review Info
| Reference ID | 112 |
|---|---|
| Researcher | Reside Team |
| Published | 12/06/2023 |
Data
| Award Number | PB-PG-0416-20019 |
|---|---|
| Status / Stage | Completed |
| Start Date | 20170902 |
| End Date | 20181231 |
| Duration (calculated) | 01 years 03 months |
| Funder/Grant study page | NIHR |
| Contracted Centre | *NHS Leicester City CCG |
| Funding Amount | £124,501.00 |
Abstract
Dementia is the commonest cause of death in England and Wales. Due to demographic factors, it will increasingly affect Black Asian and Minority Ethnic (BAME) groups, with a seven fold increase in prevalence by 2051. Diagnosis and management of dementia in BAME groups can be challenging because of cultural factors, language difficulties and the lack of effective and culturally sensitive screening tools in general practice. In Leicester (where the research will be conducted) and other places with high BAME populations there is concern that the number of cases from BAME groups on dementia registers is lower than expected. Plan Aim 1 Firstly we will examine the recorded prevalence of dementia and how this varies between ethnic groups at practice and CCG levels, using collated anonymised patient level data from all general practices. Descriptive statistics, including dementia prevalence rates for White British, Asiasian British and Black/Black British by age band will be generated and compared. A multi-level logistic regression model will be used with adjustment for covariates such as age, sex and deprivation. Secondly, we will examine the use of cognitive screening tools in general practice and how this differs according to ethnicity at practice and CCG levels. Thirdly, we will use data routinely collected by Leicestershire Partnership NHS Trust, the provider of specialist dementia services, to compare referral rates to memory clinics and other dementia services and how this differs according to ethnicity at practice and CCG levels. We will also examine the severity of dementia at presentation to specialist services and whether this differs according to ethnicity. Lastly, we will examine the prescribing of drugs to treat dementia by specialist services and whether this differs according to ethnicity. Aim 2 Using qualitative methods, we aim; firstly to understand what prompts GPs and practice nurses to consider a diagnosis of dementia and whether this differs according to ethnicity and/or proficiency in English language; secondly to explore challenges perceived by GPs in assessing cognition in BAME groups and in people who are not proficient in English, and finally to understand how GPs decide to refer to memory clinics and services to support dementia and how this may differ according to ethnic group. We will use results from the GP database study to select practices for the qualitative study, with the aim of recruiting six practice with a range of ascertainment rates for dementia in BAME groups. In each practice we will conduct a focus group comprising 6-8 practitioners. We also aim to understand the experience and views of people from BAME groups with dementia and their carers/families from initial presentation to referral specialist mental health services, if applicable. To achieve this, we will ask each of the six participating practices to identify patients from BAME groups who were diagnosed with dementia in the preceding six months. We will then interview a diverse sample of up to 30 patients and their family members/carers. Potential Benefits We will use our findings to provide recommendations to members of the public from BAME groups and primary care professionals. We then hope to develop an intervention package to assist primary care in diagnosing dementia in BAME groups. This programme of work will have the potential to reduce dementia related morbidity in BAME groups, increase quality of life and reduce need for social care.
Aims
To quantify variation between the White British population and BAME groups in the diagnosis and management of dementia in primary care 2: To explore the barriers and enablers to diagnosing and managing dementia in BAME groups in primary care as perceived by GPs, practice nurses, patients and their families