Table 8 Qualitative studies. Characteristics of the qualitative studies reviewed

Dodd et al., 2014 [39]

United Kingdom

To contrast participant’s experiences of primary care led dementia services in Bristol with existing secondary care based memory services

Qualitative participatory study

Semi-structured interview.

Questions were organised under four main themes (1) GPs making an independent dementia diagnosis (2) GPs working with memory nurses (3) patients and support person(s) experience, and (4) post-diagnostic support.

The interviews lasted, on average, 20 minutes.

Purposive.

A total of 23 participants (10 health care professionals, 6 patients and 7 support person(s)).

Eligible patients were people of any age who had been diagnosed within the previous six months with any form of dementia (MCI excluded)

Participants were recruited from GP practices in Bristol offering primary care led dementia services and secondary care health services

GPs were invited by email to participate in the study.

Health care professionals in secondary care were recruited through team meetings.

A pilot model of primary care led dementia care with three memory nurses seconded from secondary care to work within primary care with each memory nurse providing an advisory service to a group of practices.

Participating GPs attended a three-hour training session on identifying, assessing and diagnosing dementia.

Data coding and identifying evidence that related to each of the four themes from the panel meetings using a prescribed process, described by Clarke [40].

Patients and support person(s) were uniform in the praise of the work by memory nurses in both primary and secondary care settings.

Many GPs did not feel confident to conduct a dementia assessment without involving a memory nurse and reported that they valued the working relationship with the memory nurse.

Memory nurses found liaising with GPs to be cumbersome and time consuming.

Patients and support person(s) perceived there was an absence of supporting patients through the assessment and post diagnostic support from GPs. Information came from memory nurses and other memory service staff or through the media.

Dodd et al., 2016 [41]

United Kingdom

To provide a qualitative analysis of the experiences of health care professionals, patients and their families, of the new process of assessment, diagnosis and treatment of dementia within a primary care service.

Interview

Descriptive

Semi-structured interview

23 surgeries in the South Gloustershire

Four patients, three care-givers and eight health care professionals were interviewed by peer researchers (care-givers).

Primary care led dementia service in which GPs led the process of assessment and establishing a diagnosis.

A memory nurse (from secondary care) was available to support GPs and patients and support person(s) with diagnostic process.

Thematic analysis using Braun and Clarke [42] six-phase model

There were two consistently expressed concerns by all groups of participants (1) lack of post-diagnostic co-ordination (2) GP-led or multi—disciplinary assessment without secondary care support.

The advisory role of the memory nurse in the primary care service was valued by GPs. Referral to secondary care memory nurses who provided specialised assessment and post-diagnostic support, including home visits, was valued by patients and support person(s).

Manthorpe et al., 2003 [43]

United Kingdom

Supplementary papers

Iliffe et al., 1999 [27]

Iliffe et al., 2003 [28]

To explore the implications of the early recognition of dementia for inter-professional working.

Focus group interviews

Nominal group technique

Convenience sample.

Nearly 1000 GPs (247), CMHNs (79), practice (36) and CNs (146), social workers and nursing home staff took part in four focus groups in each of 24 multi-disciplinary workshops in the UK .

Thematic and interpretative analysis of data

Four key bipolar categories were derived from the workshops. (1) opportunistic versus population screening (2) referral and responsibility (3) key working and team working (4) generalist versus specialist roles.

Nurses overall were the professional group considered to have the skills and capacity in dementia care with CMHNs as specialists who may take on long-term and complex cases. The PN was identified as the practitioner most appropriate to take on screening for dementia and monitoring. It was reported that screening by the PN become a core skill and routine in primary care.