Volume 58, Issue 3 p. 557-563

Development and Validation of Quality Indicators for Dementia Diagnosis and Management in a Primary Care Setting

Marieke Perry MD

Marieke Perry MD

From the Departments of * Geriatric Medicine and § General Practice and Scientific Institute for Quality of Healthcare Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands; Alzheimer Centre Nijmegen, Nijmegen, the Netherlands; and Kalorama Foundation, Nijmegen, the Netherlands.

Search for more papers by this author
Irena Drašković PhD

Irena Drašković PhD

From the Departments of * Geriatric Medicine and § General Practice and Scientific Institute for Quality of Healthcare Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands; Alzheimer Centre Nijmegen, Nijmegen, the Netherlands; and Kalorama Foundation, Nijmegen, the Netherlands.

Search for more papers by this author
Theo van Achterberg PhD

Theo van Achterberg PhD

From the Departments of * Geriatric Medicine and § General Practice and Scientific Institute for Quality of Healthcare Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands; Alzheimer Centre Nijmegen, Nijmegen, the Netherlands; and Kalorama Foundation, Nijmegen, the Netherlands.

Search for more papers by this author
Monique van Eijken PhD

Monique van Eijken PhD

From the Departments of * Geriatric Medicine and § General Practice and Scientific Institute for Quality of Healthcare Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands; Alzheimer Centre Nijmegen, Nijmegen, the Netherlands; and Kalorama Foundation, Nijmegen, the Netherlands.

Search for more papers by this author
Peter Lucassen MD, PhD

Peter Lucassen MD, PhD

From the Departments of * Geriatric Medicine and § General Practice and Scientific Institute for Quality of Healthcare Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands; Alzheimer Centre Nijmegen, Nijmegen, the Netherlands; and Kalorama Foundation, Nijmegen, the Netherlands.

Search for more papers by this author
Myrra Vernooij-Dassen PhD

Myrra Vernooij-Dassen PhD

From the Departments of * Geriatric Medicine and § General Practice and Scientific Institute for Quality of Healthcare Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands; Alzheimer Centre Nijmegen, Nijmegen, the Netherlands; and Kalorama Foundation, Nijmegen, the Netherlands.

Search for more papers by this author
Marcel Olde Rikkert MD, PhD

Marcel Olde Rikkert MD, PhD

From the Departments of * Geriatric Medicine and § General Practice and Scientific Institute for Quality of Healthcare Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands; Alzheimer Centre Nijmegen, Nijmegen, the Netherlands; and Kalorama Foundation, Nijmegen, the Netherlands.

Search for more papers by this author
First published: 11 March 2010
Citations: 25
Address correspondence to Marieke Perry, Department of Geriatric Medicine 925, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB, Nijmegen, the Netherlands. E-mail: [email protected]

Abstract

OBJECTIVES: To construct a set of quality indicators (QIs) for dementia diagnosis and management in a primary care setting.

DESIGN: RAND modified Delphi method, including a postal survey, a stakeholders consensus meeting, a scientific expert consensus meeting, and a demonstration project.

SETTING: Primary care.

PARTICIPANTS: General practitioners (GPs), primary care nurses (PCNs), and informal caregivers (ICs) in postal survey and stakeholders consensus meeting. Eight national dementia experts in scientific consensus meeting. Thirteen GPs in the demonstration project.

MEASUREMENTS: Mean face validity and feasibility scores. Compliance rates using GPs' electronic medical record data.

RESULTS: The initial set consisted of 31 QIs. Most indicators showed moderate or good face validity and feasibility scores. Consensus panels reduced the preliminary set used in the demonstration project to 24 QIs. The overall compliance to the QIs was 45.3%. Discriminative validity of the set was good; significant differences in adherence were found between GPs with high and low levels of patients aged 65 and older in their practice, with and without PCNs, and with positive and negative attitudes toward dementia (all P<.05). Based on the demonstration project, one QI was excluded. The final set consisted of 23 QIs; 15 QIs contained innovative quality criteria on collaboration between GPs and PCNs, referral criteria, and assessment of caregivers' needs.

CONCLUSION: This new set of dementia QIs is feasible, reliable, and valid and can be used to improve primary dementia care. Because of the innovative quality criteria, the set is complementary to the existing dementia QIs.