Abstract Body

Background and purpose: Clinicians, researchers, and Alzheimer Societies, stress the importance of an early dementia diagnosis in a mild stage. However, whether this is an improvement in patients’ health and well-being is still debated. Ideally, shared-decision making (SDM) is implemented to discuss the potential benefits and harms of an early diagnosis and disclosure with patients. This study explores experiences and considerations of GPs regarding an (early) diagnostic trajectory for dementia and implementation of SDM therein.

Methods: In this qualitative study, GPs and practice-based nurses were interviewed. Topics included views concerning early dementia diagnosis, the decision-making process for starting a diagnostic trajectory, and views on the implementation of SDM in this regard.

Results: 16 GPs and practice-based nurses in the Netherlands were interviewed. Several considerations concerning the timing of a dementia diagnosis were identified including; (1) decrease in patients’ quality of life (QoL) due to an (early) diagnosis, (2) potential advantages of an early diagnosis for patients and their significant others (3) the possibility of a misdiagnosis (4) experiences related to a dementia diagnosis in a late disease stage.

Several patient and dyad related factors were identified that could hinder or facilitate the implementation of SDM in general practice.

Conclusions: Most GPs were in favour of a timely (instead of an early) diagnostic trajectory (i.e. initiated at the right time for patients and significant others to meet their needs and expectations) and emphasized the importance of their patients’ QoL. GPs favour patient involvement in deciding on an (early) diagnostic trajectory, but several barriers and facilitators (e.g. patients’ expectations regarding treatment) affect SDM.