Work

Health system outcomes following an integrated intervention to improve detection of cognitive impairment using a novel training program for primary care

Year: 2025

Type: article

Abstract: BACKGROUND: Primary care providers (PCPs) are at the forefront of evaluating cognitive concerns and detecting mild cognitive impairment and dementia, but they generally lack training and tools to do so. METHOD: An intervention consisting of education webinars integrated with checklists in the electronic health record (EHR) and a set of exam room tools was developed and implemented across a large primary care system of 14 community-based clinics (94 PCPs). Outcomes from the EHR included the number of cognitive assessments recorded by PCPs in the EHR and the number of patients who received a new diagnosis of mild cognitive impairment or dementia. RESULT: Over two years of the program, the average number of cognitive assessments entered by quarter into the EHR increased from 6.6 to 42.8 (p = 0.01). In addition, the average number of new diagnoses of mild cognitive impairment or dementia per quarter increased from 17.0 to 37.8 (p = 0.02). See Figures 1 and 2. Referrals to specialty care were reported as being more useful, because they more often included assessments of cognitive function and a review of potential reversible causes of cognitive impairment. CONCLUSION: An intervention integrating PCP education with workflow tools increased cognitive testing and diagnoses of mild cognitive impairment and dementia in a large primary care health system. Such change is essential for patients to receive improved care for Alzheimer's disease and related dementias.

Source: Alzheimer s & Dementia

DOI: 10.1002/alz70858_101395