Primary care physicians' perspectives and challenges on managing multimorbidity for patients with dementia: a Japan–Michigan qualitative comparative study

書誌事項

公開日
2023-06-27
資源種別
journal article
権利情報
  • https://creativecommons.org/licenses/by/4.0
  • https://creativecommons.org/licenses/by/4.0
DOI
  • 10.1186/s12875-023-02088-4
公開者
Springer Science and Business Media LLC

説明

<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Multimorbidity management can be extremely challenging in patients with dementia. This study aimed to elucidate the approaches of primary care physicians in Japan and the United States (US) in managing multimorbidity for patients with dementia and discuss the challenges involved.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>This qualitative study was conducted through one-on-one semi-structured interviews among primary care physicians, 24 each from Japan and Michigan, US. Thematic and content analyses were performed to explore similarities and differences among each country’s data.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Primary care physicians in Japan and Michigan applied a relaxed adherence to the guidelines for patients’ chronic conditions. Common challenges were the suboptimal consultation time, the insufficient number or ability of care-coordinating professionals, patients’ conditions such as difficulties with self-management, living alone, behavioral issues, and refusal of care support. Unique challenges in Japan were free-access medical systems and not being sure about the patients’ will in end-of-life care. In Michigan, physicians faced challenges in distance and lack of transportation between clinics and patients’ homes and in cases where patients lacked the financial ability to acquire good care.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>To improve the quality of care for patients with multimorbidity and dementia, physicians would benefit from optimal time and compensation allocated for this patient group, guidelines for chronic conditions to include information regarding changing priority for older adults with dementia, and the close collaboration of medical and social care and community resources with support of skilled care-coordinating professionals.</jats:p></jats:sec>

収録刊行物

  • BMC Primary Care

    BMC Primary Care 24 (1), 2023-06-27

    Springer Science and Business Media LLC

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