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

Jennings, Aisling A.; Foley, Tony; Walsh, Kieran A.; Coffey, Alice; Browne, John P.; Bradley, Colin P.

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

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.contributor.funder	Health Service Executive, Ireland	en
dc.contributor.funder	Irish College of General Practitioners	en
dc.contributor.funder	Atlantic Philanthropies	en
dc.date.accessioned	2019-11-23T07:14:59Z
dc.date.available	2019-11-23T07:14:59Z
dc.date.issued	2018-06-13
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.description.status	Peer reviewed	en
dc.description.version	Published Version	en
dc.format.mimetype	application/pdf	en
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.doi	10.1002/gps.4918	en
dc.identifier.eissn	1099-1166
dc.identifier.endpage	1176	en
dc.identifier.issn	0885-6230
dc.identifier.issued	9	en
dc.identifier.journaltitle	International Journal of Geriatric Psychiatry	en
dc.identifier.startpage	1163	en
dc.identifier.uri	https://hdl.handle.net/10468/9204
dc.identifier.volume	33	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

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