Primary care physicians' attitudes towards cognitive screening: findings from a national postal survey

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Abstract
Objective: The objectives of this paper are: (a) to determine Canadian family physicians' attitudes towards cognitive screening, (b) to identify what cognitive screening tools are being used, (c) to investigate how they rate these tools' effectiveness and (d) to identify the attributes of an ideal cognitive screening tool for the primary care setting.Method: Postal survey questionnaire of a random sample of 249 practicing members of the College of Family Physicians of Canada.Results: Response rate was 52%. The majority of physicians ‘Agreed’ or ‘Strongly Agreed’ that cognitive impairment assessment is important in primary care (89%), and ‘Disagreed’ or ‘Strongly Disagreed’ that it should be left to specialists (92%). However, 35% were undecided when asked if assessment in primary care would lead to better outcomes. The most frequently used assessment tools were Mini–Mental Status Exam (MMSE), Clock Drawing, Delayed Word Recall, Standardized MMSE and Alternating Sequences, but were mainly rated as only ‘Good’ in terms of perceived effectiveness. Validity/accuracy was identified as the top attribute of an ideal screening tool. Female physicians were more likely to have a positive attitude towards cognitive assessment. Younger physicians, those in group practices, or those with either ≤ 20% or 61–80% of elderly patients in their practice indicated a shorter ideal time to administer a cognitive screening tool.Conclusion: Despite general agreement that primary care physicians have an important role in cognitive screening, there is less agreement that it leads to better outcomes. The development of a superior screening tool to be used in the primary care setting is needed. Copyright © 2009 John Wiley & Sons, Ltd.

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