Preferences and Perspectives of Australian General Practitioners Towards a New “Four-in-One” Risk Assessment Tool for Preventative Health: The LEAD! GP Project

Article type: Research Article

Authors: Chong, Terence W.H.^{a; b; c; *} | Rego, Thomas^{a; c} | Lai, Rhoda^a | Westphal, Alissa^{a; b} | Pond, Constance Dimity^d | Curran, Eleanor^{a; b; c} | Kootar, Scherazad^{e; f} | Peters, Ruth^g | Anstey, Kaarin J.^{e; f} | Lautenschlager, Nicola T.^{a; b; c}

Affiliations: [a] Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Parkville, Australia | [b] St Vincent’s Hospital Melbourne, Kew, Australia | [c] North Western Mental Health, Royal Melbourne Hospital, Parkville, Australia | [d] Wicking Centre for Dementia Education, University of Tasmania, Hobart, Australia | [e] School of Psychology, University of New South Wales, Sydney, Australia | [f] Lifecourse Ageing Research Centre, Neuroscience Research Australia, Sydney, Australia | [g] The George Institute for Global Health, University of New South Wales, Sydney, Australia

Correspondence: [*] Correspondence to: Dr. Terence W.H. Chong, Department of Psychiatry, The University of Melbourne and St Vincent’s Hospital Melbourne, St George’s Campus, St Vincent’s Hospital Melbourne, 283 Cotham Road, Kew, Victoria 3101, Australia. Tel.: +61 3 9231 8485; Fax: +61 3 9231 8477; E-mail: twhc@unimelb.edu.au.

Abstract: Background: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. Objective: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. Methods: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. Results: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. Conclusion: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.

Keywords: Alzheimer’s disease, dementia, diabetes, heart disease, general practice, primary care, risk, stroke

DOI: 10.3233/JAD-230287

Journal: Journal of Alzheimer's Disease, vol. 94, no. 2, pp. 801-814, 2023