Pathways to care for people with dementia: An international multicentre study. (1st December 2019)

• Record Type: Journal Article
• Authors: Volpe, Umberto; Amin, Hania; Ayinde, Olatunde O.; Burns, Alistair; Chan, Wai Chi; David, Renaud; Dejanovic, Slavica Djukic; Djokic, Gorica; Eraslan, Defne; Fischer, Giulia A.L.; Gracia‐García, Patricia; Hamdani, Syed Usman; Han, Changsu; Jafri, Hussain; Kallivayalil, Roy A.; Kriekaart, Roderick Leonard; Kua, Ee Heok; Lam, Linda C.W.; Lecic‐Tosevski, Dusica; Leroi, Iracema; Lobo, Antonio; Mihai, Adriana; Minhas, Fareed Aslam; Mistry, Heena; Ogundele, Afolakemi T.; Olde Rikkert, Marcel G.M.; Olivera, Javier; Palumbo, Claudia; Parker, Angela; Pejuskovic, Bojana; Riese, Florian; Robert, Philippe; Semrau, Maya; Stoppe, Gabriela; Sudhakar, Sanu; Tirintica, Andreea Raluca; Tofique, Sehrish; Tsoi, Chris; Wolski, Lucas; Yalug, Irem; Wang, Huali; Yu, Xin; Sartorius, Norman;
• Is Part Of: International journal of geriatric psychiatry. Volume 35:Number 2(2020)
• Page Start: 163
• Page End: 173
• Publication Date: 2019-12-01
• Subjects: dementia -- geriatric psychiatry -- health care policy -- outcome -- pathways to care -- time to diagnosis; Geriatric psychiatry -- Periodicals; Geriatric Psychiatry -- Periodicals; 618.97689
• DOI: 10.1002/gps.5223
• Languages: English
• ISSNs: 0885-6230

Abstract

Abstract : 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.