General practitioners' knowledge, attitudes, and experiences of managing behavioural and psychological symptoms of dementia: A mixed-methods systematic review

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dc.contributor.author Jennings, Aisling A.
dc.contributor.author Foley, Tony
dc.contributor.author Walsh, Kieran A.
dc.contributor.author Coffey, Alice
dc.contributor.author Browne, John P.
dc.contributor.author Bradley, Colin P.
dc.date.accessioned 2019-11-23T07:14:59Z
dc.date.available 2019-11-23T07:14:59Z
dc.date.issued 2018-06-13
dc.identifier.citation Jennings, A.A., Foley, T., Walsh, K.A., Coffey, A., Browne, J.P. and Bradley, C.P. (2018) 'General practitioners' knowledge, attitudes, and experiences of managing behavioural and psychological symptoms of dementia: A mixed‐methods systematic review'. International Journal of Geriatric Psychiatry, 33(9), pp.1163-1176. doi:10.1002/gps.4918 en
dc.identifier.volume 33 en
dc.identifier.issued 9 en
dc.identifier.startpage 1163 en
dc.identifier.endpage 1176 en
dc.identifier.issn 0885-6230
dc.identifier.uri http://hdl.handle.net/10468/9204
dc.identifier.doi 10.1002/gps.4918 en
dc.description.abstract Objectives: To synthesise the existing published literature on general practitioners (GP)'s knowledge, attitudes, and experiences of managing behavioural and psychological symptoms of dementia (BPSD) with a view to informing future interventions. Methods: We conducted a systematic review and synthesis of quantitative and qualitative studies that explored GPs' experiences of managing BPSD (PROSPERO protocol registration CRD42017054916). Seven electronic databases were searched from inception to October 2017. Each stage of the review process involved at least 2 authors working independently. The meta-ethnographic approach was used to synthesise the findings of the included studies while preserving the context of the primary data. The Confidence in the Evidence from Reviews of Qualitative research (CERQual) was used to assess the confidence in our individual review findings. Results: Of the 1638 articles identified, 76 full texts were reviewed and 11 were included. Three main concepts specific to GPs' experiences of managing BPSD emerged: unmet primary care resource needs, justification of antipsychotic prescribing, and the pivotal role of families. A “line of argument” was drawn, which described how in the context of resource limitations a therapeutic void was created. This resulted in GPs being over reliant on antipsychotics and family caregivers. These factors appeared to culminate in a reactive response to BPSD whereby behaviours and symptoms could escalate until a crisis point was reached. Conclusion: This systematic review offers new insights into GPs' perspectives on the management of BPSD and will help to inform the design and development of interventions to support GPs managing BPSD. en
dc.description.sponsorship Atlantic Philanthropies (PREPARED, Primary Care Education, Pathways and Research of Dementia, a 3‐year grant (2015‐2018)); Health Service Executive (PREPARED project) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher John Wiley and Sons Ltd en
dc.relation.uri https://onlinelibrary.wiley.com/doi/full/10.1002/gps.4918
dc.rights © 2018 The Authors. International Journal of Geriatric Psychiatry Published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. en
dc.rights.uri http://creativecommons.org/licenses/by-nc/4.0/ en
dc.subject Behavioural and psychological symptoms (BPSD) en
dc.subject Dementia en
dc.subject General practitioners (GPs) en
dc.subject Meta‐ethnography en
dc.subject Mixed methods en
dc.subject Neuropsychiatric symptoms (NPS) en
dc.subject Qualitative research en
dc.subject Systematic review en
dc.title General practitioners' knowledge, attitudes, and experiences of managing behavioural and psychological symptoms of dementia: A mixed-methods systematic review en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Aisling Jennings, Department of General Practice, School of Medicine, University College Cork, Cork, Ireland. +353-21-490-3000 Email: aisling.jennings@ucc.ie en
dc.internal.availability Full text available en
dc.description.version Published Version en
dc.contributor.funder Health Service Executive, Ireland en
dc.contributor.funder Irish College of General Practitioners en
dc.contributor.funder Atlantic Philanthropies en
dc.description.status Peer reviewed en
dc.identifier.journaltitle International Journal of Geriatric Psychiatry en
dc.internal.IRISemailaddress aisling.jennings@ucc.ie en
dc.internal.IRISemailaddress j.browne@ucc.ie en
dc.identifier.eissn 1099-1166


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© 2018 The Authors. International Journal of Geriatric Psychiatry Published by John Wiley & Sons Ltd.  This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. Except where otherwise noted, this item's license is described as © 2018 The Authors. International Journal of Geriatric Psychiatry Published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
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