ArticleCMAJ open
Impact of the Quebec Alzheimer Plan on the detection and management of Alzheimer disease and other neurocognitive disorders in primary health care: a retrospective study.
Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 21 citations in OpenAlex.
- Use of lecanemab and donanemab in the Canadian healthcare system: Evidence, challenges, and areas for future research.The journal of prevention of Alzheimer's disease · 2025Review
- Rural-Urban Differences in Healthcare Use in Persons With Dementia Between 2000 and 2019: A Quebec Population-Based Study.Healthcare policy = Politiques de sante · 2024Article
- Description of organizational and clinician characteristics of primary dementia care in Canada: a multi-method study.BMC primary care · 2022Article
- The association between the level of institutional support for dementia care in primary care practices and the quality of dementia primary care: A retrospective chart review.Alzheimer's & dementia (New York, N. Y.) · 2022Article
- Decision making under uncertainty in the diagnosis and management of Alzheimer's Disease in primary care: A study protocol applying concepts from neuroeconomics.Frontiers in medicine · 2022Article
- Primary care clinicians' knowledge, attitudes, and practices concerning dementia: They are willing and need support.Canadian family physician Medecin de famille canadien · 2021Article
- Article
- Needs of patients with dementia and their caregivers in primary care: lessons learned from the Alzheimer plan of Quebec.BMC family practice · 2021Article
- Sex differences in the management of persons with dementia following a subnational primary care policy intervention.International journal for equity in health · 2020Article
- Assessing care models implemented in primary healthcare for persons with dementia: a mixed-methods study protocol.BMJ open · 2020Article
- Nursing Care Coordination in Primary Healthcare for Patients with Complex Needs: A Comparative Case Study.International journal of integrated careArticle
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Quebec Alzheimer Plan aims to improve care provided to patients with neurocognitive disorders in Family Medicine Groups (FMGs) (multidisciplinary team-based primary care practices). The objective of this study was to determine changes in the detection and management of neurocognitive disorders following implementation of the plan, in 2014.
methodsThis was a retrospective chart review before and after implementation of the Quebec Alzheimer Plan in 13 FMGs. We reviewed 1919 randomly selected charts of patients aged 75 years or more and 945 randomly selected charts of patients in this age group with neurocognitive disorders. In the first group, selected outcomes were proportion of patients with documentation of cognitive status, documented diagnosis of neurocognitive disorder, documented cognitive testing and referral to a memory clinic. In patients with neurocognitive disorders, the outcomes were number of contacts with an FMG, quality of follow-up score (documented assessments in 10 domains: cognitive testing, functional status, behavioural and psychological symptoms of dementia, weight, caregiver needs, driving status, home care needs, community service needs, absence of anticholinergic medication and management of dementia medications) and proportion referred to a memory clinic.
resultsSignificantly more patients aged 75 or more had documentation of cognitive status in their chart after plan implementation than before implementation (440 [45.1%] v. 351 [37.2%]) (odds ratio [OR] 1.46, 95% confidence interval [CI] 1.18-1.81). No significant changes were found in documented diagnosis of neurocognitive disorders, cognitive testing or referral to a memory clinic. Among patients with neurocognitive disorders, the number of contacts with an FMG (adjusted mean difference 1.6, 95% CI 0.3-2.8) and quality of follow-up score (adjusted mean difference 6.6, 95% CI 3.9-9.2) increased significantly, without significant changes in the number of referrals to a memory clinic.
interpretationThe results suggest that the Quebec Alzheimer Plan is feasible and beneficial in terms of detection and management of neurocognitive disorders, without an increase in referral to specialists. The findings will be used to scale up the Quebec Alzheimer Plan and to develop the Canadian federal dementia strategy.
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