Inequalities in the Quality and Safety of Post-Diagnostic Primary Care for People With Dementia: A Scoping Review

被引：0

作者：

Morris, Charlotte ^{[1
,2
]}

Techache, Roukia ^{[3
]}

Davies, Katie ^{[4
,5
]}

Blakeman, Tom ^{[1
,2
]}

Kontopantelis, Evangelos ^{[6
]}

Ashcroft, Darren M. ^{[1
,2
,7
]}

Robinson, Dame Louise ^{[8
]}

机构：

[1] Univ Manchester, NIHR Sch Primary Care Res, Dept Primary Care & Hlth Serv Res, Manchester, England

[2] Univ Manchester, Natl Inst Hlth & Care Res Greater Manchester Patie, Sch Hlth Sci, Fac Biol Med & Hlth, Manchester, England

[3] Salford Royal Hosp, Fdn Programme Doctor, Salford, England

[4] Univ Manchester, Manchester Acad Hlth Sci Ctr, Ctr Primary Care, Natl Inst Hlth Res,Sch Primary Care Res, Manchester, England

[5] Univ Manchester, Healthy Ageing Res Grp, Manchester, England

[6] Univ Manchester, Div Informat Imaging & Data Sci, Manchester, England

[7] Univ Manchester, Fac Biol Med & Hlth, Sch Hlth Sci, Div Pharm & Optometry, Manchester, England

[8] Newcastle Univ, Populat Hlth Sci Inst, Fac Med Sci, Newcastle Upon Tyne, England

来源：

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY | 2024年 / 39卷 / 12期

关键词：

dementia; health inequality; patient safety; primary care; quality; POTENTIALLY INAPPROPRIATE MEDICATIONS; ANTIPSYCHOTIC-DRUG USE; DWELLING OLDER-ADULTS; ANTIDEMENTIA DRUGS; PHARMACOLOGICAL-TREATMENT; ALZHEIMERS-DISEASE; ETHNIC DISPARITIES; HEALTH-CARE; POPULATION; PRESCRIPTION;

D O I：

10.1002/gps.70035

中图分类号：

R592 [老年病学]; C [社会科学总论];

学科分类号：

03 ; 0303 ; 100203 ;

摘要：

IntroductionInternational guidelines make recommendations for the delivery of safe, high-quality primary care for people with dementia including prescribing, personalised care planning and regular holistic reviews. It is unclear how the quality and safety of this healthcare varies with socio-economic factors.ObjectiveThis scoping review aimed to understand the depth and breadth of existing evidence exploring socio-economic variation in the quality and safety of primary care for people with dementia.MethodsPrescribing and care planning indicators of high-quality, safe primary care were defined from guidance. Composite and proxy markers of socio-economic status (SES) were defined. EMBASE, MEDLINE, PsychInfo, The Cochrane Database of Systematic Reviews, and databases were searched. Studies in English, on human participants from 2006 onwards were eligible. Narrative synthesis was conducted. Studies explored how one or more selected indicators (anti-dementia medication and anti-psychotic prescribing, potentially inappropriate prescribing (PIP), medication review, dementia review or care planning) varied with a recognised marker of SES in people with dementia.ResultsSearches identified 1980 studies after removing duplicates. 385 full texts were reviewed, with 53 eligible for inclusion (51 quantitative, 2 reviews). Most identified studies explored prescribing processes (50 quantitative, 2 reviews), with 2 exploring annual review. There was evidence of substantial disparity in quality and safety indicators in studies exploring prescribing; 20/29 (69%) of studies exploring anti-dementia medication prescribing found those with markers of lower SES were significantly less likely to receive these. 16/28 studies exploring PIP/Anti-psychotics found significant disparities in safe prescribing for those with markers of lower SES. Neither study exploring annual reviews found any significant differences across SES.ResultsSearches identified 1980 studies after removing duplicates. 385 full texts were reviewed, with 53 eligible for inclusion (51 quantitative, 2 reviews). Most identified studies explored prescribing processes (50 quantitative, 2 reviews), with 2 exploring annual review. There was evidence of substantial disparity in quality and safety indicators in studies exploring prescribing; 20/29 (69%) of studies exploring anti-dementia medication prescribing found those with markers of lower SES were significantly less likely to receive these. 16/28 studies exploring PIP/Anti-psychotics found significant disparities in safe prescribing for those with markers of lower SES. Neither study exploring annual reviews found any significant differences across SES.ConclusionWe found evidence of disparity in the quality and safety of post-diagnostic primary care for people with dementia based on SES, particularly for a range of prescribing indicators. Further work exploring inequalities in care planning and reviews for people with dementia is needed to understand existing inequalities in the quality and safety of primary care for people with dementia.

引用

页数：20

共 105 条

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