Identifying barriers to diagnosing dementia following incentivisation and policy pressures: General practitioners' perspectives

Overcoming barriers to earlier diagnosis of dementia in primary care is a core ambition of several government initiatives in the UK, with incentives put in place to promote earlier recognition by general practitioners and referral to specialists. This study was designed to explore general practitioners' opinions concerning barriers to diagnosing dementia, following implementation of strategies aimed at reducing them. The study involved in-depth, semi-structured interviews with 13 general practitioners from seven practices in North London or the West Midlands. Thematic analysis of interview transcripts was carried out using the Framework approach. We identified four major themes: organisational factors, clinician-related factors, patient-related factors and societal influences. The study findings revealed barriers previously unidentified in the literature which warrant further investigation, including the limits of diagnostic tools, lack of cultural applicability of these tools, and prioritisation of severe over mildly symptomatic patients by dementia services.