| 18 the most obvious HCPs to explore these preferences as recommended in the Dementia Guideline of the Dutch College of General Practitioners (19). Although GPs tend to value the “rightness” of time for starting a dementia diagnostic trajectory, they also consider this a complex issue (17). They experience barriers such as lack of time, confidence and knowledge or are held back due to their own attitudes towards early diagnosis, stigma or therapeutic nihilism (20-22). Insights in patient preferences and considerations concerning starting a diagnostic trajectory for dementia could support GPs to initiate the SDM process about starting a diagnostic trajectory, and it could assist in optimizing clinical guidelines (23). Previous reviews have touched upon patient preferences around dementia diagnoses, specifically on systematic population screening (24), barriers towards help seeking (25) and diagnostic disclosure (12). All have concluded that preferences around diagnosing dementia are complex and multi-factorial. They, however, do not address considerations and preferences for starting a diagnostic trajectory in case of actual memory problems. Therefore, an integrative review is conducted to explore and map the preferences and considerations of PwMCs and their SOs regarding starting a diagnostic trajectory for dementia. Method This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (registration number: CRD42020190580). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed for article selection (26). Design An integrative review was conducted in line with the methodology described by Whittemore and Knafl (2005) (27). This methodology allows for the inclusion of quantitative, qualitative, and mixed-method studies. By including studies with different methodologies, all aspects of patients’ preferences could be integrated to get an overall understanding of preferences in the context of a timely dementia diagnosis.
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