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Conditions required to ensure successful detection and management of mild cognitive impairment in primary care: A Delphi consultation study in China

OBJECTIVE: Detection and management of mild cognitive impairment (MCI) in primary care has been recognized internationally as one of the strategies that can be employed to delay the development of dementia. However, little is known about what role primary care should play. This study aimed to develo...

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Autores principales: Lu, Yuan, Liu, Chaojie, Yu, Dehua, Wells, Yvonne
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9540221/
https://www.ncbi.nlm.nih.gov/pubmed/36211650
http://dx.doi.org/10.3389/fpubh.2022.943964
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author Lu, Yuan
Liu, Chaojie
Yu, Dehua
Wells, Yvonne
author_facet Lu, Yuan
Liu, Chaojie
Yu, Dehua
Wells, Yvonne
author_sort Lu, Yuan
collection PubMed
description OBJECTIVE: Detection and management of mild cognitive impairment (MCI) in primary care has been recognized internationally as one of the strategies that can be employed to delay the development of dementia. However, little is known about what role primary care should play. This study aimed to develop a checklist of conditions necessary for successfully detecting and managing mild cognitive impairment in primary care in China. METHODS: This study employed the Delphi method to establish expert consensus on the conditions required for successfully detecting and managing MCI in primary care in China. Twenty-four experts who specialized in general practice, public health, neuropsychology, or community health service management rated the importance of pre-defined conditions (44 items measuring providers' preparedness, patient engagement, and system support in line with the Chronic Care Model). The degree of consensus among the experts was measured using four indicators: median ≥ 4, mean ≥3.5, Co-efficient of Variance < 0.25, and retention in the checklist required ≥ 80% agreement with a rating of important or essential. The checklist and descriptions of the conditions were revised according to the experts' feedback and then sent out for repeated consultations along with a summary of the results of the previous round of consultations. Consensus was achieved after the second round of consultations, which was completed by 22 of the experts. RESULTS: The experts endorsed a checklist of 47 conditions required for successful detection and management of MCI in primary care in China. These conditions were categorized into four domains: prepared general practitioners (17 items), engaged patients (15 items), organizational efforts (11 items), and environmental support (4 items). CONCLUSIONS: Successful detection and management of MCI in primary care in China requires a dedicated and competent workforce of general practitioners, as well as the engagement of patients and family caregivers. Adequate support from healthcare organizations, health system arrangements, and the broader society is needed to enable effective interactions between general practitioners and patients and efficient delivery of the services required to detect and manage MCI.
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spelling pubmed-95402212022-10-08 Conditions required to ensure successful detection and management of mild cognitive impairment in primary care: A Delphi consultation study in China Lu, Yuan Liu, Chaojie Yu, Dehua Wells, Yvonne Front Public Health Public Health OBJECTIVE: Detection and management of mild cognitive impairment (MCI) in primary care has been recognized internationally as one of the strategies that can be employed to delay the development of dementia. However, little is known about what role primary care should play. This study aimed to develop a checklist of conditions necessary for successfully detecting and managing mild cognitive impairment in primary care in China. METHODS: This study employed the Delphi method to establish expert consensus on the conditions required for successfully detecting and managing MCI in primary care in China. Twenty-four experts who specialized in general practice, public health, neuropsychology, or community health service management rated the importance of pre-defined conditions (44 items measuring providers' preparedness, patient engagement, and system support in line with the Chronic Care Model). The degree of consensus among the experts was measured using four indicators: median ≥ 4, mean ≥3.5, Co-efficient of Variance < 0.25, and retention in the checklist required ≥ 80% agreement with a rating of important or essential. The checklist and descriptions of the conditions were revised according to the experts' feedback and then sent out for repeated consultations along with a summary of the results of the previous round of consultations. Consensus was achieved after the second round of consultations, which was completed by 22 of the experts. RESULTS: The experts endorsed a checklist of 47 conditions required for successful detection and management of MCI in primary care in China. These conditions were categorized into four domains: prepared general practitioners (17 items), engaged patients (15 items), organizational efforts (11 items), and environmental support (4 items). CONCLUSIONS: Successful detection and management of MCI in primary care in China requires a dedicated and competent workforce of general practitioners, as well as the engagement of patients and family caregivers. Adequate support from healthcare organizations, health system arrangements, and the broader society is needed to enable effective interactions between general practitioners and patients and efficient delivery of the services required to detect and manage MCI. Frontiers Media S.A. 2022-09-23 /pmc/articles/PMC9540221/ /pubmed/36211650 http://dx.doi.org/10.3389/fpubh.2022.943964 Text en Copyright © 2022 Lu, Liu, Yu and Wells. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Public Health
Lu, Yuan
Liu, Chaojie
Yu, Dehua
Wells, Yvonne
Conditions required to ensure successful detection and management of mild cognitive impairment in primary care: A Delphi consultation study in China
title Conditions required to ensure successful detection and management of mild cognitive impairment in primary care: A Delphi consultation study in China
title_full Conditions required to ensure successful detection and management of mild cognitive impairment in primary care: A Delphi consultation study in China
title_fullStr Conditions required to ensure successful detection and management of mild cognitive impairment in primary care: A Delphi consultation study in China
title_full_unstemmed Conditions required to ensure successful detection and management of mild cognitive impairment in primary care: A Delphi consultation study in China
title_short Conditions required to ensure successful detection and management of mild cognitive impairment in primary care: A Delphi consultation study in China
title_sort conditions required to ensure successful detection and management of mild cognitive impairment in primary care: a delphi consultation study in china
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9540221/
https://www.ncbi.nlm.nih.gov/pubmed/36211650
http://dx.doi.org/10.3389/fpubh.2022.943964
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