๐”– Bobbio Scriptorium
โœฆ   LIBER   โœฆ

Survey of physician practices for community-dwelling agitated dementia patients

โœ Scribed by Christopher C. Colenda; James C. Leist; Stephen R. Rapp


Publisher
John Wiley and Sons
Year
1996
Tongue
English
Weight
876 KB
Volume
11
Category
Article
ISSN
0885-6230

No coin nor oath required. For personal study only.

โœฆ Synopsis


In order to gain a better understanding of physician clinical reasoning and clinical practices for community-dwelling agitated dementia patients, we conducted a small survey of geriatric psychiatrists, primary care physicians and neurologists. The survey asked physician respondents to give a likelihood estimate of how often they would carry out one of 13 different pharmacologic and psychosocial interventions. Intervention by specialty group analyses found that geriatric psychiatrists were more likely to recommend neuroleptic medications and dementia support group activities, but less likely to recommend referral to behavioral specialists than the other physician groups. Neurologists were more likely to recommend dementia support groups than primary care physicians, but they were also more likely to recommend institutional placement than the other physician groups. Primary care physicians were more likely to recommend hydroxyzine than either neurologists or geriatric psychiatrists. Multivariate ordinal logistic regression analyses found that older physicians and primary care physicians expressed a lower likelihood of recommending dementia day care programs and a higher likelihood of recommending hydroxyzine. Women physicians, however, expressed a high likelihood of recommending dementia day care programs. The results of the survey suggest that personal and specialty characteristics of physicians influence the types of treatment recommendations made for agitated dementia patients. The results may help community-based dementia care programs to develop strategies that broaden physician involvement in multidisciplinary team management for these patients. KEY WORDS-phySiCianS; practice patterns; agitated dementia patients Physicians are important decision-makers for agitated dementia patients (ADPs). ADPs represent behavioral emergencies that require prompt recognition and intervention in order to avoid physical injury and disruption of institutional and home environments. Agitated behaviors have been shown to occur in clusters and are often accompanied by discrete psychiatric symptoms such as delusions, hallucinations or depression (Baker et al., 1991). Cognitive decline, functional impairment, depressed affect, social networks of poor quality, male gender and struggles with activities of daily living (ADLs) have been shown to be associated with higher rates of agitation (Cariaga et al.,


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