Evidence map›Paper›PMID 37370035›Full record

ArticleBMC primary care2023

Primary care physicians' perspectives and challenges on managing multimorbidity for patients with dementia: a Japan-Michigan qualitative comparative study.

Shinji Tsunawaki, Michiko Abe, Melissa DeJonckheere, Christine T Cigolle, Kristin K Philips, Ellen B Rubinstein, Masakazu Matsuda, Michael D Fetters, Machiko Inoue

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC primary care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.3field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Patient views on blood-based biomarker tests for Alzheimer's disease in primary care.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026
    Article
  3. Article
  4. Review
  5. Multimorbidity in dementia: Current perspectives and future challenges.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025
    Review
  6. Article
  7. Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 6 institutions in 3 countries.

Shinji TsunawakiOmaezaki Family Medicine Center, Omaezaki, Shizuoka, Japan.
Michiko AbeDepartment of Family and Community Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.
Melissa DeJonckheereDepartment of Family Medicine, University of Michigan, Ann Arbor, MI, USA.
Christine T CigolleDepartment of Family Medicine, University of Michigan, Ann Arbor, MI, USA.
Kristin K PhilipsEducation and Clinical Center (GRECC), VA Ann Arbor Healthcare System (VAAAHS) Geriatric Research, Ann Arbor, MI, USA.
Ellen B RubinsteinDepartment of Sociology and Anthropology, North Dakota State University, Fargo, ND, USA.
Masakazu MatsudaShizuoka Family Medicine Program, Shizuoka, Hamamatsu, Japan.
Michael D FettersDepartment of Family Medicine, University of Michigan, Ann Arbor, MI, USA.
Machiko InoueShizuoka Family Medicine Program, Shizuoka, Hamamatsu, Japan. machiko@hama-med.ac.jp.
Geriatric Research Education and Clinical Center · USHamamatsu University School of Medicine · JPUniversity of Michigan–Ann Arbor · USFuji Kiko (Japan) · JPNorth Dakota State University · USShizuoka Medical Center · JP

Funding

Statistical Data EnclaveP30AG012846 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI VICKI A. FREEDMAN · 1999 to 2026
$23.2M
NIA NIH HHS P30 AG012846
6 · The paper itself

Abstract

backgroundMultimorbidity management can be extremely challenging in patients with dementia. This study aimed to elucidate the approaches of primary care physicians in Japan and the United States (US) in managing multimorbidity for patients with dementia and discuss the challenges involved.

methodsThis qualitative study was conducted through one-on-one semi-structured interviews among primary care physicians, 24 each from Japan and Michigan, US. Thematic and content analyses were performed to explore similarities and differences among each country's data.

resultsPrimary care physicians in Japan and Michigan applied a relaxed adherence to the guidelines for patients' chronic conditions. Common challenges were the suboptimal consultation time, the insufficient number or ability of care-coordinating professionals, patients' conditions such as difficulties with self-management, living alone, behavioral issues, and refusal of care support. Unique challenges in Japan were free-access medical systems and not being sure about the patients' will in end-of-life care. In Michigan, physicians faced challenges in distance and lack of transportation between clinics and patients' homes and in cases where patients lacked the financial ability to acquire good care.

conclusionsTo improve the quality of care for patients with multimorbidity and dementia, physicians would benefit from optimal time and compensation allocated for this patient group, guidelines for chronic conditions to include information regarding changing priority for older adults with dementia, and the close collaboration of medical and social care and community resources with support of skilled care-coordinating professionals.

Indexed as

DementiaPhysicians, Primary CareAgedChronic DiseaseHumansJapanMichiganMultimorbidityUnited StatesCare resourcesDementiaGuidelinesJapan-US comparisonMultidisciplinary supportMultimorbidity managementMultiple chronic conditionsPrimary care physiciansQualitative study

Identifiers

PMID37370035
PMCPMC10294331
OpenAlexW4382344784

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.