PMID- 29900592
OWN - NLM
STAT- Publisher
LR  - 20240227
IS  - 1099-1166 (Electronic)
IS  - 0885-6230 (Print)
IS  - 0885-6230 (Linking)
VI  - 33
IP  - 9
DP  - 2018 Jun 13
TI  - General practitioners' knowledge, attitudes, and experiences of managing 
      behavioural and psychological symptoms of dementia: A mixed-methods systematic 
      review.
PG  - 1163-76
LID - 10.1002/gps.4918 [doi]
AB  - 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.
CI  - (c) 2018 The Authors. International Journal of Geriatric Psychiatry Published by 
      John Wiley & Sons Ltd.
FAU - Jennings, Aisling A
AU  - Jennings AA
AUID- ORCID: 0000-0002-9246-3955
AD  - Department of General Practice, School of Medicine, University College Cork, 
      Cork, Ireland.
FAU - Foley, Tony
AU  - Foley T
AD  - Department of General Practice, School of Medicine, University College Cork, 
      Cork, Ireland.
FAU - Walsh, Kieran A
AU  - Walsh KA
AD  - School of Public Health, University College Cork, Cork, Ireland.
AD  - Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, 
      Cork, Ireland.
AD  - Centre for Gerontology and Rehabilitation, School of Medicine, University College 
      Cork, Cork, Ireland.
FAU - Coffey, Alice
AU  - Coffey A
AD  - Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland.
FAU - Browne, John P
AU  - Browne JP
AD  - School of Public Health, University College Cork, Cork, Ireland.
FAU - Bradley, Colin P
AU  - Bradley CP
AD  - Department of General Practice, School of Medicine, University College Cork, 
      Cork, Ireland.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20180613
PL  - England
TA  - Int J Geriatr Psychiatry
JT  - International journal of geriatric psychiatry
JID - 8710629
PMC - PMC6099359
OTO - NOTNLM
OT  - behavioural and psychological symptoms (BPSD)
OT  - dementia
OT  - general practitioners (GPs)
OT  - meta-ethnography
OT  - mixed methods
OT  - neuropsychiatric symptoms (NPS)
OT  - qualitative research
OT  - systematic review
EDAT- 2018/06/15 06:00
MHDA- 2018/06/15 06:00
PMCR- 2018/08/20
CRDT- 2018/06/15 06:00
PHST- 2017/12/18 00:00 [received]
PHST- 2018/04/03 00:00 [accepted]
PHST- 2018/06/15 06:00 [entrez]
PHST- 2018/06/15 06:00 [pubmed]
PHST- 2018/06/15 06:00 [medline]
PHST- 2018/08/20 00:00 [pmc-release]
AID - GPS4918 [pii]
AID - 10.1002/gps.4918 [doi]
PST - aheadofprint
SO  - Int J Geriatr Psychiatry. 2018 Jun 13;33(9):1163-76. doi: 10.1002/gps.4918.