Objective:

This pilot initiative seeks to educate and encourage primary care practitioners (PCPs) to adopt Alzheimer's disease (AD) care pathways, understand implementation barriers, and identify optimization opportunities.

Background:

Organizations such as the Alzheimer’s Association increasingly advocate for earlier detection of dementia and AD to enable timely support. Earlier AD detection requires establishing care pathways to appropriately screen, diagnose, and refer patients, ultimately enhancing patient care and support.

Design/Methods:

In May 2023, a group of multidisciplinary dementia experts convened to develop an AD consensus care pathway. The care pathway was implemented across three sites: University of North Carolina (UNC) and Midwestern University (MWU) clinics in Illinois and Arizona. The site leads completed educational sessions with PCPs while administering baseline, 1-month, and 3-month follow-up assessments.

Results:

Twenty PCPs across all sites completed the baseline and 1-month follow-up assessment, and 4 UNC PCPs completed all follow-up assessments to date. Although only 10% (n=2) of participants agreed with understanding the differences between different AD stages at baseline, 65% (n=13) expressed agreement with the statement after 1-month. Additionally, UNC baseline results indicated that 0-25% of participants agreed with statements regarding an understanding of when to refer patients to specialists or the appropriate use of available biomarker testing. 100% of participants agreed with such statements following training. Participants reported multiple barriers to implementing pathway guidelines, including time limitations for conducting assessments and inability to order tests within the electronic health record (EHR).

Conclusions:

The initial results from the pilot highlighted gaps in PCP awareness and training which improved after the educational intervention, with initial data indicating increased confidence and understanding of AD risk stratification, diagnosis, and referral practices. Future opportunities to enhance care pathway adoption include embedding it directly into the EHR to streamline processes.