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Challenges in detecting and managing mild cognitive impairment in primary care: a focus group study in Shanghai, China.

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posted on 2023-07-14, 05:33 authored by Yuan LuYuan Lu, Chaojie LiuChaojie Liu, Yvonne WellsYvonne Wells, Dehua Yu

Introduction: Detection of mild cognitive impairment (MCI) is essential in slowing progression to dementia. Primary care plays a vital role in detecting and managing MCI. The chronic care model (CCM) provides effective methods to manage chronic diseases. Objective: This study aimed to explore how MCI services are delivered in primary care in China. Methods: Focus group interviews were conducted face to face among MCI stakeholders from six community health centres (CHCs) involved in the € friendly community programme' in Shanghai, China. A total of 124 MCI stakeholders were interviewed, consisting of 6 groups (n=42) of general practitioners (GPs), 3 groups (n=18) of CHC managers, 4 groups (n=32) of people with MCI and 4 groups (n=32) of informal caregivers. Content and thematic analyses were performed using a combination of induction and deduction approaches. Results: Three major themes emerged from the data corresponding to the CCM framework: hesitant patients, unprepared providers and misaligned environments. While the public are hesitant to seek medical attention for MCI problems, due to misunderstanding, social stigma and a lack of perceived benefits, GPs and CHCs are not well prepared either, due to lack of knowledge and a shortage of GPs, and a lack of policy, funding and information support. None of these issues can be addressed separately without tackling the others. Conclusion: This study combined the diverse perceptions of all the main stakeholders to detect and manage MCI in primary care settings in China. A vicious circle was found among the three interconnected CCM domains, creating a gridlock that should be addressed through a system's approach targeting all of the above-mentioned aspects.

Funding

This project was supported by the Australian Government Research Training Program Fees Offset (RTP Fees Offset) and the La Trobe University Full Fee Research Scholarship (LTUFFRS) (Award number not available). The research was partly funded by Shanghai Municipal Health Commission, China (201940495).

History

Publication Date

2022-09-20

Journal

BMJ Open

Volume

12

Issue

9

Article Number

e062240

Pagination

10p.

Publisher

BMJ Group

ISSN

2044-6055

Rights Statement

© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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