Abstract Body

Background and purpose

Dementia is a diagnosis that can be made by a general practitioner. However, 60% of patients with memory complaints are diagnosed in a memory clinic. In the past few years, research in the field of dementia has focused on advanced and extensive diagnostic testing to determine a diagnosis as early as possible. It is unknown whether patients and informal caregivers benefit from extensive diagnostic testing in memory clinics, and what motives general practitioners have when referring such patients to secondary care. This study aims to explore general practitioners’ considerations regarding referral of patients with memory complaints.

Methods

Between October 2020 and December 2020, Dutch general practitioners participated in semi-structured interviews. Interviews were audio-recorded, transcribed verbatim, and thematically analysed using MaxQDA software.

Results

Interviews with 11 general practitioners revealed multiple clusters of considerations: patient and caregiver related, healthcare system or organisational related, perspective of the general practitioner, diagnostic instruments, and care related considerations. Participants highlighted the importance of local agreements regarding diagnostic work-up and subsequent care in primary care. The local differences in agreements and the general practitioners’ attitude towards the topic were amplifying factors that influenced their decision on referral. Furthermore, treatment and care after diagnosis were mentioned as important factors to consider.

Conclusion

General practitioners described a range of considerations and exposed a great heterogeneity in the implementation of the diagnostic and referral process in patients with memory complaints in primary care throughout the Netherlands.