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Table 1 Dementia indicators for the quality and outcomes framework

From: Tailored educational intervention for primary care to improve the management of dementia: the EVIDEM-ED cluster randomized controlled trial

Indicator Description
Dementia (DEM) indicator 1 The practice reports the number of patients with dementia on its register and the number of people with dementia as a proportion of its list size.
Rationale: A register is a prerequisite for the organization of good primary care for a particular patient group. There is little evidence to support screening for dementia and it is expected that the diagnosis will largely be recorded from correspondence when patients are referred to secondary care with suspected dementia or as an additional diagnosis when a patient is seen in secondary care. However, it is also important to include patients where it is inappropriate or not possible to refer to a secondary care provider for a diagnosis and where the general practitioner has made a diagnosis based on their clinical judgment and knowledge of the patient.
Dementia (DEM) indicator 2 The percentage of patients diagnosed with dementia whose care has been reviewed by the practice in the preceding 15 months.
Rationale: The face-to-face review should focus on support needs of the patient and their carer. In particular the review should address four key issues:
(1) An appropriate physical and mental health review for the patient.
(2) If applicable, the carer’s needs for information commensurate with the stage of the illness and his or her and the patient’s health and social care needs.
(3) If applicable, the impact of caring on the caregiver.
(4) Communication and co-ordination arrangements with secondary care (if applicable).
A series of well-designed cohort and case control studies have demonstrated that people with Alzheimer-type dementia do not complain of common physical symptoms, but experience them to the same degree as the general population. Patient assessments should therefore include the assessment of any behavioral changes caused by: concurrent physical conditions (for example, joint pain or intercurrent infections) new appearance of features intrinsic to the disorder (for example, wandering) and delusions or hallucinations due to the dementia or as a result of caring behavior (for example, being dressed by a carer).
Depression should also be considered since it is more common in people with dementia than those without the diagnosis and sources of help and support (bearing in mind issues of confidentiality).
  1. Table adapted from the Quality and Outcomes Framework guidance 2009/10, BMA 2009 [14].