Barriers to treating dementia in immigrant patients

Dementia is a global problem in an ageing population but rates amongst older immigrants are increasing twice as fast. Understanding the barriers in the provision of primary care is essential. This mixed-methods study in the Netherlands offers recommendations for immediate implementation. It found that greater awareness is needed in this population, along with culturally sensitive cognitive screening tools and specialised memory clinics. Dementia is often regarded as a taboo subject and assessment of care needs is challenging due to linguistic barriers. The need to support informal caregivers and for access to professional translators was also recognised. 

Finding patients with heart failure with preserved ejection fraction

To improve care for people with preserved ejection fraction heart failure we first need to identify more patients. In a real-world sample Deaton and colleagues detailed characteristic features using data from two practices in the east of England, and found 36% of patients on heart failure registers were likely to have a preserved ejection fraction. They were more likely to be older, have comorbidities, and be overweight or obese. Confirmation of diagnosis was hampered by inconsistent or missing information like natriuretic peptides and echocardiogram parameters.

Candidate perspectives on the MICGP exit examination

How do candidates feel about a clinical competency test (CCT) as an exiting exam to qualify as a GP? The MICGP CCT was introduced in Ireland in 2015 as part of a triangulated assessment, and is structurally similar to the CSA of the MRCGP in the UK. A mixed-methods study from Foley and colleagues found that registrars felt it had a positive educational impact, and that it was fair and relevant. But they found it costly both in financial and, importantly, psychological terms, with stress around time management being highlighted.