Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Parkville, Australia.
St Vincent's Hospital Melbourne, Kew, Australia.
J Alzheimers Dis. 2023;94(2):801-814. doi: 10.3233/JAD-230287.
Dementia risk reduction is a public health priority and general practitioners (GPs) play a pivotal role in preventative healthcare. Therefore, risk assessment tools should be designed with GPs' preferences and perspectives in mind.
The LEAD! GP project aimed to investigate Australian GPs' preferences and perspectives relating to design, use and implementation of a new risk assessment tool that simultaneously calculates risk for four outcomes- dementia, diabetes mellitus, myocardial infarct, and stroke.
A mixed methods study using semi-structured interviews of a diverse group of 30 Australian GPs was conducted. Interview transcripts were analyzed thematically. Demographics and questions that elicited categorical answers were analyzed descriptively.
Overall, GPs felt that preventative healthcare was important with some finding it rewarding, and others finding it difficult. GPs currently use many risk assessment tools. GPs' perception of the usefulness and negatives/barriers of tools related to clinical practice applicability, patient engagement, and practical aspects. The largest barrier was lack of time. GPs responded positively to the concept of a four-in-one tool and preferred it to be relatively short, supported by practice nurses and some patient involvement, linked to education resources, available in different formats, and integrated into practice software.
GPs recognize the importance of preventative healthcare and the potential benefit of a new tool that simultaneously predicts risk for those four outcomes. Findings provide important guidance to inform the final development and piloting of this tool with potential to improve efficiency and practical integration of preventative healthcare for dementia risk reduction.
降低痴呆风险是公共卫生的重点，全科医生（GP）在预防保健中起着关键作用。因此，风险评估工具的设计应考虑到 GP 的偏好和观点。
LEAD！GP 项目旨在调查澳大利亚全科医生对一种新的风险评估工具的设计、使用和实施的偏好和观点，该工具同时计算痴呆、糖尿病、心肌梗死和中风四种结果的风险。
采用半结构化访谈的混合方法，对 30 名澳大利亚全科医生进行了多样化的小组访谈。对访谈记录进行主题分析。对人口统计学和引出分类答案的问题进行描述性分析。
总体而言，GP 认为预防保健很重要，有些医生认为这很有回报，而有些则认为这很困难。GP 目前使用许多风险评估工具。GP 对工具的有用性和负面因素/障碍的看法与临床实践适用性、患者参与度和实际方面有关。最大的障碍是缺乏时间。GP 对四合一工具的概念反应积极，希望它相对较短，得到执业护士和一些患者的支持，与教育资源相关联，有多种格式，并且集成到实践软件中。
GP 认识到预防保健的重要性，以及一种新工具同时预测这四种结果风险的潜在好处。研究结果为最终开发和试用该工具提供了重要指导，有可能提高预防痴呆风险的效率和实际整合。
