Service Provision for Dementia Patients in the Outpatient Setting - Who Should be Responsible? A Survey of 400 Primary Care Physicians

Aims: The growing number of patients suffering from dementia increases demand for medical services. At the same time, there is a gap between treatment guidelines and actual service provision. Current guidelines endorse primary care physicians as key service providers for dementia patients. Here we investigate how primary care physicians view their own service provision and who, in their opinion, should be responsible for providing medical care for patients suffering from dementia. Methods: 400 primary care physicians were surveyed during certified continuing medical education courses using a telephone dialogue procedure. Results: 71 % of primary care physicians reported using neuropsychological or screening tests, while 29 % did not. 53 % reported prescribing antidementia agents regularly, while 47 % reported referring patients to a specialist for such treatments. 20 % reported prescribing an increased number of generic antidementia agents after the price-reductions of 2011. Primary care physicians reported that specific dementia care should be provided by specialized neurologists or psychiatrists (60 %) or memory clinics (12 %). Only 24 % of primary care physicians reported that they would prefer to provide specialized care themselves. Conclusion: A majority of primary care physicians does not wish to undertake the task of providing specific dementia care. They consider this area of medical care to be the responsibility particularly of specialists in neuropsychiatry and specialized memory clinics. Thus, treatment from specialists should be taken into consideration in guidelines on medical care of dementia patients.