Pathways to care for people with dementia: An international multicentre study.
- Volpe U Department of Neuroscience/DIMSC, Università Politecnica delle Marche, Ancona, Italy.
- Amin H WHO Collaborating Centre for Mental Health Research and Training, Institute of Psychiatry, Rawalpindi, Pakistan.
- Ayinde OO WHO Collaborating Centre for Research and Training in Mental Health, Neurosciences and Drug and Alcohol abuse, Department of Psychiatry, College of Medicine, University of Ibadan, Nigeria.
- Burns A Greater Manchester NIHR Clinical Research Network, University of Manchester, UK, Manchester, UK.
- Chan WC Department of Psychiatry, The University of Hong Kong, Hong Kong, China.
- David R CoBTEK lab, Research Memory center, University Côte d'Azur, Nice, France.
- Dejanovic SD Clinic for Mental Disorders, Belgrade, Serbia.
- Djokic G Clinic for Mental Disorders, Belgrade, Serbia.
- Eraslan D Istanbul Psikiyatri Enstitusu, Istanbul, Turkey.
- Fischer GAL Division of Old Age Psychiatry, Psychiatric University Hospital Zurich, Zurich, Switzerland.
- Gracia-García P Department of Medicine and Psychiatry, University of Zaragoza; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain.
- Hamdani SU WHO Collaborating Centre for Mental Health Research and Training, Institute of Psychiatry, Rawalpindi, Pakistan.
- Han C Department of Psychiatry, Mind-Medical Research Lab, Korea University, Seoul, Korea.
- Jafri H Alzheimer Pakistan, Lahore, Pakistan.
- Kallivayalil RA Department of Psychiatry, Pushpagiri Institute of Medical Sciences, Thiruvalla, Kerala, India.
- Kriekaart RL Department of Geriatrics, Radboud Alzheimer Centre, Donders Institute for Brain Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
- Kua EH Department of Psychological Medicine, National University Hospital, Singapore.
- Lam LCW Department of Psychiatry, The University of Hong Kong, Hong Kong, China.
- Lecic-Tosevski D Serbian Academy of Sciences and Arts, Institute of Mental Health, Belgrade, Serbia.
- Leroi I Global Brain Health Institute, Department of Psychiatry, School of Medicine, Trinity College, Dublin, Ireland.
- Lobo A Department of Medicine and Psychiatry, University of Zaragoza; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain.
- Mihai A University of Medicine and Pharmacy, Romania.
- Minhas FA Human Development Research Foundation, Islamabad, Pakistan.
- Mistry H Greater Manchester NIHR Clinical Research Network, University of Manchester, UK, Manchester, UK.
- Ogundele AT Old Age Unit, Neuropsychiatric Hospital, Aro, Abeokuta, Nigeria.
- Olde Rikkert MGM Department of Geriatrics, Radboud Alzheimer Centre, Donders Institute for Brain Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
- Olivera J Psychiatry Service, Hospital San Jorge, Huesca, Spain.
- Palumbo C Department of Neuroscience, University of Bari, Bari, Italy.
- Parker A Greater Manchester NIHR Clinical Research Network, University of Manchester, UK, Manchester, UK.
- Pejuskovic B Institute of Mental Health, School of Medicine, University of Belgrade, Belgrade, Serbia.
- Riese F Division of Old Age Psychiatry, Psychiatric University Hospital Zurich, Zurich, Switzerland.
- Robert P CoBTEK lab, Research Memory center, University Côte d'Azur, Nice, France.
- Semrau M Global Health and Infection Department, Brighton and Sussex Medical School, Brighton; and King's College, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
- Stoppe G MentAge, Basel, Switzerland.
- Sudhakar S Department of Psychiatry, Pushpagiri Institute of Medical Sciences, Thiruvalla, Kerala, India.
- Tirintica AR Global Brain Health Institute, Department of Psychiatry, School of Medicine, Trinity College, Dublin, Ireland.
- Tofique S Pakistan Institute of Living and Learning, Karachi, Pakistan.
- Tsoi C Department of Psychological Medicine, National University Hospital, Singapore.
- Wolski L MentAge, Basel, Switzerland.
- Yalug I Pakistan Institute of Living and Learning, Karachi, Pakistan.
- Wang H Dementia Care and Research Center, Peking University Institute of Mental Health (Sixth Hospital), Beijing Dementia Key Lab, Beijing, 100191, China.
- Yu X Dementia Care and Research Center, Peking University Institute of Mental Health (Sixth Hospital), Beijing Dementia Key Lab, Beijing, 100191, China.
- Sartorius N Association for the Improvement of Mental Health Programmes (AMH), Geneva, Switzerland.
- 2019-10-29
Published in:
- International journal of geriatric psychiatry. - 2020
dementia
geriatric psychiatry
health care policy
outcome
pathways to care
time to diagnosis
Aged
Aged, 80 and over
Antidepressive Agents
Critical Pathways
Dementia
Female
Health Services Accessibility
Humans
Internationality
Male
Psychotropic Drugs
Referral and Consultation
Specialization
English
OBJECTIVE
The aim of the present study was to characterize the clinical pathways that people with dementia (PwD) in different countries follow to reach specialized dementia care.
METHODS
We recruited 548 consecutive clinical attendees with a standardized diagnosis of dementia, in 19 specialized public centres for dementia care in 15 countries. The WHO "encounter form," a standardized schedule that enables data concerning basic socio-demographic, clinical, and pathways data to be gathered, was completed for each participant.
RESULTS
The median time from the appearance of the first symptoms to the first contact with specialist dementia care was 56 weeks. The primary point of access to care was the general practitioners (55.8%). Psychiatrists, geriatricians, and neurologists represented the most important second point of access. In about a third of cases, PwD were prescribed psychotropic drugs (mostly antidepressants and tranquillizers). Psychosocial interventions (such as psychological counselling, psychotherapy, and practical advice) were delivered in less than 3% of situations. The analyses of the "pathways diagram" revealed that the path of PwD to receiving care is complex and diverse across countries and that there are important barriers to clinical care.
CONCLUSIONS
The study of pathways followed by PwD to reach specialized care has implications for the subsequent course and the outcome of dementia. Insights into local differences in the clinical presentations and the implementation of currently available dementia care are essential to develop more tailored strategies for these patients, locally, nationally, and internationally.
The aim of the present study was to characterize the clinical pathways that people with dementia (PwD) in different countries follow to reach specialized dementia care.
METHODS
We recruited 548 consecutive clinical attendees with a standardized diagnosis of dementia, in 19 specialized public centres for dementia care in 15 countries. The WHO "encounter form," a standardized schedule that enables data concerning basic socio-demographic, clinical, and pathways data to be gathered, was completed for each participant.
RESULTS
The median time from the appearance of the first symptoms to the first contact with specialist dementia care was 56 weeks. The primary point of access to care was the general practitioners (55.8%). Psychiatrists, geriatricians, and neurologists represented the most important second point of access. In about a third of cases, PwD were prescribed psychotropic drugs (mostly antidepressants and tranquillizers). Psychosocial interventions (such as psychological counselling, psychotherapy, and practical advice) were delivered in less than 3% of situations. The analyses of the "pathways diagram" revealed that the path of PwD to receiving care is complex and diverse across countries and that there are important barriers to clinical care.
CONCLUSIONS
The study of pathways followed by PwD to reach specialized care has implications for the subsequent course and the outcome of dementia. Insights into local differences in the clinical presentations and the implementation of currently available dementia care are essential to develop more tailored strategies for these patients, locally, nationally, and internationally.
- Language
-
- English
- Open access status
- green
- Identifiers
-
- DOI 10.1002/gps.5223
- PMID 31657091
- Persistent URL
- https://folia.unifr.ch/global/documents/245076
Statistics
Document views: 23
File downloads:
- fulltext.pdf: 0