To facilitate the use of blood biomarker testing for Alzheimer’s Disease (AD) in primary care.

Blood biomarker tests for AD can significantly improve diagnostic accuracy and streamline identification of patients who should be referred to neurology for consideration of monoclonal antibody therapy for AD. However, PCPs lack clinical experience with testing, and are uncertain about the benefits and limitations of AD blood testing. 

Based on user-centered design methodology, we conducted a series of 5 focus group meetings with PCPs to co-design a pathway tool to support decision-making and results communication about AD blood testing in primary care. PCPs identified main areas of need the pathway should address, suggested adaptations, and provided feedback. We transcribed sessions and qualitatively analyzed transcripts using the RITA method; and measured perceived utility and satisfaction with the pathway.

12 PCPs from Family Medicine (n=4), Internal Medicine (n=7) and Geriatrics (n=1) participated in 5 focus group sessions. 10 Females and 2 males participated, who were mostly white (n=11). PCPs represented a broad range of experience, ranging from <5 years in practice (n=1), 6-10 years (n=2), 11-15 years (n=5), 16-20 years (n=1) to >20 years (n=3).

PCPs identified design targets, or high priority areas the pathway should address: 1) defining the benefits and appropriate use of testing; 2) providing information to share with patients to support shared decision-making; and 3) enabling comprehensive results communication. We developed and refined a pathway meeting these design targets through multiple rounds of iterative feedback. PCPs believed the pathway would be easy and feasible to use in their clinical practice.

PCPs value tools to support clinical and shared decision-making about AD blood tests, and these tools can be developed with user-centered design methodology. Involving stakeholders in the development of tools may increase usability and feasibility of tools, and ultimately improve uptake among PCPs.