Online dementia training for GPs and practice nurses

General practitioners are often the first port of call for people with dementia. Luke Bishop talks to a GP about the importance of a good level of dementia knowledge among his profession.

Whether referring people on for diagnosis, signposting people with dementia and their carers towards relevant services and information or managing medication, GPs have a pivotal role to play in many people's dementia journeys.

Dr Alex Turnbull

Through campaigns such as Worried about your memory? Alzheimer's Society has been working closely with GPs across the country to raise dementia awareness, improve diagnosis rates and reduce the inappropriate prescription of antipsychotic medications.

Meeting these aims will greatly improve the lives of people with dementia but a recent survey conducted by Alzheimer's Society found that just 37 per cent of GPs felt they had sufficient basic training on dementia. Additionally, 71 per cent of those surveyed said they wished to find out more online, while 75 per cent said they specifically wanted to know more about managing behavioural symptoms of dementia.

Online learning

Alzheimer's Society recently launched a free online training programme for GPs, GP trainees and practice nurses in partnership with BMJ Learning. The programme not only includes basic information about dementia but also sections dealing with early diagnosis and non-drug treatments to address behavioural problems.

Dr Alex Turnbull is a locum GP based in Wigan who has worked closely with Alzheimer's Society for several years, helping to develop a local dementia strategy and raise dementia awareness among fellow professionals. He has used the new resource himself and believes it will be a useful tool for GPs who want to know more about dementia and how to treat it.

He says,

'The average busy GP trying to keep abreast of developments with dementia is aware of the problem but not necessarily confident about how to manage dementia. For example, on usage of medications slowing progression, I thought the learning module was very informative.'

Positive impact

Dr Turnbull says that GPs have been aware of dementia but not necessarily the positive impact of diagnosis in terms of access to drugs and services and planning for the future. However, he believes this is changing. For example, he says that 1,500 people in Wigan now have a dementia diagnosis (out of an estimated 3,000) compared to 1,000 four years ago.

'There's a big challenge for the GP profession in terms of awareness and training and a lot of it is already underway. I think that if you were to do the same survey in a year's time you would notice significant changes.

'It is hard to predict how long it will take to get to a situation where at least 90 per cent of cases are diagnosed, anyone who would benefit from treatments would be on them, carers needs are being met and social services are involved where they should be.

How long it will take to reach is very hard to say but I hope that in five to 10 years we will be approaching that situation.'

Working together

Dr Turnbull believes that the positive changes are down to GPs working more closely with mental health and memory services, as well as local social services, to increase diagnosis rates and therefore improve outcomes for people with dementia and carers.

The area where he believes improvements have been most marked is in the prescription of antipsychotic drugs for behavioural problems - a traditional over-reliance on this is now being addressed.

'The learning programme encourages GPs not to reach for the prescription pad when they are called to assess somebody at a care home. There's a lot of pressure to help without having much time and what I've taken from the learning is that there are no shortcuts.

'To do it properly we have to spend the time and be prepared to work with the care homes. You have to spend time working with the homes to develop a better approach - I can see it being difficult for busy GPs, but community matrons could help.'

'It's also about getting the staff better trained to realise that there are other ways to help people with disturbances as it may be environmental factors or, for example, a urinary infection that is the issue. I think that in a couple of years' time antipsychotic drugs will be used much less than they are at the moment.'

The free online module available at BMJ Learning is aimed at GPs, GP trainees and practice nurses, and may be accessed by anyone who registers with the site.