Understanding diagnostic settings and carer experiences for dementia diagnosis in Australia
Background Australian guidelines advocate referral to comprehensive memory services for dementia diagnosis, but many patients may be diagnosed elsewhere. Aims To determine common settings for dementia diagnosis in Australia and to compare patient and carer experience between settings. Methods Explor...
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| Vydáno v: | Internal medicine journal Ročník 51; číslo 7; s. 1126 - 1135 |
|---|---|
| Hlavní autoři: | , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
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Melbourne
John Wiley & Sons Australia, Ltd
01.07.2021
Wiley Subscription Services, Inc |
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| ISSN: | 1444-0903, 1445-5994, 1445-5994 |
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| Abstract | Background
Australian guidelines advocate referral to comprehensive memory services for dementia diagnosis, but many patients may be diagnosed elsewhere.
Aims
To determine common settings for dementia diagnosis in Australia and to compare patient and carer experience between settings.
Methods
Exploratory cross‐sectional study of patients with dementia admitted to a Melbourne sub‐acute hospital. Patients who had capacity to participate were included; carers were recruited for patients without capacity. Participants completed an interviewer‐administered survey which asked them to recall the diagnostic setting, discussions about diagnosis and management (clinical care) and overall experience of diagnosis. Descriptive statistics were applied and open‐ended questions were analysed using inductive and deductive coding approaches.
Results
From 81 eligible participants, 74 consented to participate (one patient, 74 carers). Participants reported dementia diagnosis occurred a median of 24 months before interview, in the following settings: hospitals (31.3%), private specialist clinics (29.7%), memory clinics (14.9%), general practice (13.5%), community health services (9.5%) and residential care (1.4%). Recall of discussions about dementia‐modulating medications was higher in participants diagnosed in memory clinics and private specialist clinics (70%) compared to other settings (15%) (P < 0.001). Discussion about living circumstances was highest in hospitals (87% vs 40%) (P < 0.001). One third of participants reported dissatisfaction with their experience. Reported satisfaction was highest for memory clinics.
Conclusion
Results suggest majority of people with dementia are diagnosed outside memory services. Significant variability exists in experiences between services, with a high proportion of participants expressing dissatisfaction with their experience with dementia diagnosis. Strategies to standardise diagnosis of dementia, measure and improve quality of care across all settings are required. |
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| AbstractList | Australian guidelines advocate referral to comprehensive memory services for dementia diagnosis, but many patients may be diagnosed elsewhere. This study aimed to determine common settings for dementia diagnosis in Australia and to compare patient and carer experience between settings.
Exploratory cross-sectional-study of patients with dementia admitted to a Melbourne sub-acute hospital. Patients who had capacity to participate were included, carers were recruited for patients without capacity. Participants completed an interviewer-administered-survey which asked them to recall the diagnostic setting, discussions about diagnosis and management (clinical care), and overall experience of diagnosis. Descriptive statistics were applied and open-ended questions were analyzed using inductive and deductive coding approaches.
From 81 eligible participants, 74 consented to participate (1 patient,74 carers). Participants reported dementia diagnosis occurred a median of 24 months before interview, in the following settings: hospitals (31.3%), private specialist clinics (29.7%), memory clinics (14.9%), general practice (13.5%), community health services (9.5%) and residential care (1.4%). Recall of discussions about dementia-modulating-drugs were higher in participants diagnosed in memory clinics and private specialist clinics (70%) compared to other settings (15%)(p < 0.001). Discussion about living circumstances was highest in hospitals (87%vs40%)(p < 0.001). A third of participants reported dissatisfaction with their experience. Reported satisfaction was highest for memory clinics.
Results suggest majority of people with dementia are diagnosed outside memory services. Significant variability exists in experiences between services, with a high proportion of participants expressing dissatisfaction with their experience with dementia diagnosis. Strategies to standardize diagnosis of dementia, measure and improve quality of care across all settings is required. This article is protected by copyright. All rights reserved. BackgroundAustralian guidelines advocate referral to comprehensive memory services for dementia diagnosis, but many patients may be diagnosed elsewhere.AimsTo determine common settings for dementia diagnosis in Australia and to compare patient and carer experience between settings.MethodsExploratory cross‐sectional study of patients with dementia admitted to a Melbourne sub‐acute hospital. Patients who had capacity to participate were included; carers were recruited for patients without capacity. Participants completed an interviewer‐administered survey which asked them to recall the diagnostic setting, discussions about diagnosis and management (clinical care) and overall experience of diagnosis. Descriptive statistics were applied and open‐ended questions were analysed using inductive and deductive coding approaches.ResultsFrom 81 eligible participants, 74 consented to participate (one patient, 74 carers). Participants reported dementia diagnosis occurred a median of 24 months before interview, in the following settings: hospitals (31.3%), private specialist clinics (29.7%), memory clinics (14.9%), general practice (13.5%), community health services (9.5%) and residential care (1.4%). Recall of discussions about dementia‐modulating medications was higher in participants diagnosed in memory clinics and private specialist clinics (70%) compared to other settings (15%) (P < 0.001). Discussion about living circumstances was highest in hospitals (87% vs 40%) (P < 0.001). One third of participants reported dissatisfaction with their experience. Reported satisfaction was highest for memory clinics.ConclusionResults suggest majority of people with dementia are diagnosed outside memory services. Significant variability exists in experiences between services, with a high proportion of participants expressing dissatisfaction with their experience with dementia diagnosis. Strategies to standardise diagnosis of dementia, measure and improve quality of care across all settings are required. Background Australian guidelines advocate referral to comprehensive memory services for dementia diagnosis, but many patients may be diagnosed elsewhere. Aims To determine common settings for dementia diagnosis in Australia and to compare patient and carer experience between settings. Methods Exploratory cross‐sectional study of patients with dementia admitted to a Melbourne sub‐acute hospital. Patients who had capacity to participate were included; carers were recruited for patients without capacity. Participants completed an interviewer‐administered survey which asked them to recall the diagnostic setting, discussions about diagnosis and management (clinical care) and overall experience of diagnosis. Descriptive statistics were applied and open‐ended questions were analysed using inductive and deductive coding approaches. Results From 81 eligible participants, 74 consented to participate (one patient, 74 carers). Participants reported dementia diagnosis occurred a median of 24 months before interview, in the following settings: hospitals (31.3%), private specialist clinics (29.7%), memory clinics (14.9%), general practice (13.5%), community health services (9.5%) and residential care (1.4%). Recall of discussions about dementia‐modulating medications was higher in participants diagnosed in memory clinics and private specialist clinics (70%) compared to other settings (15%) (P < 0.001). Discussion about living circumstances was highest in hospitals (87% vs 40%) (P < 0.001). One third of participants reported dissatisfaction with their experience. Reported satisfaction was highest for memory clinics. Conclusion Results suggest majority of people with dementia are diagnosed outside memory services. Significant variability exists in experiences between services, with a high proportion of participants expressing dissatisfaction with their experience with dementia diagnosis. Strategies to standardise diagnosis of dementia, measure and improve quality of care across all settings are required. Australian guidelines advocate referral to comprehensive memory services for dementia diagnosis, but many patients may be diagnosed elsewhere.BACKGROUNDAustralian guidelines advocate referral to comprehensive memory services for dementia diagnosis, but many patients may be diagnosed elsewhere.To determine common settings for dementia diagnosis in Australia and to compare patient and carer experience between settings.AIMSTo determine common settings for dementia diagnosis in Australia and to compare patient and carer experience between settings.Exploratory cross-sectional study of patients with dementia admitted to a Melbourne sub-acute hospital. Patients who had capacity to participate were included; carers were recruited for patients without capacity. Participants completed an interviewer-administered survey which asked them to recall the diagnostic setting, discussions about diagnosis and management (clinical care) and overall experience of diagnosis. Descriptive statistics were applied and open-ended questions were analysed using inductive and deductive coding approaches.METHODSExploratory cross-sectional study of patients with dementia admitted to a Melbourne sub-acute hospital. Patients who had capacity to participate were included; carers were recruited for patients without capacity. Participants completed an interviewer-administered survey which asked them to recall the diagnostic setting, discussions about diagnosis and management (clinical care) and overall experience of diagnosis. Descriptive statistics were applied and open-ended questions were analysed using inductive and deductive coding approaches.From 81 eligible participants, 74 consented to participate (one patient, 74 carers). Participants reported dementia diagnosis occurred a median of 24 months before interview, in the following settings: hospitals (31.3%), private specialist clinics (29.7%), memory clinics (14.9%), general practice (13.5%), community health services (9.5%) and residential care (1.4%). Recall of discussions about dementia-modulating medications was higher in participants diagnosed in memory clinics and private specialist clinics (70%) compared to other settings (15%) (P < 0.001). Discussion about living circumstances was highest in hospitals (87% vs 40%) (P < 0.001). One third of participants reported dissatisfaction with their experience. Reported satisfaction was highest for memory clinics.RESULTSFrom 81 eligible participants, 74 consented to participate (one patient, 74 carers). Participants reported dementia diagnosis occurred a median of 24 months before interview, in the following settings: hospitals (31.3%), private specialist clinics (29.7%), memory clinics (14.9%), general practice (13.5%), community health services (9.5%) and residential care (1.4%). Recall of discussions about dementia-modulating medications was higher in participants diagnosed in memory clinics and private specialist clinics (70%) compared to other settings (15%) (P < 0.001). Discussion about living circumstances was highest in hospitals (87% vs 40%) (P < 0.001). One third of participants reported dissatisfaction with their experience. Reported satisfaction was highest for memory clinics.Results suggest majority of people with dementia are diagnosed outside memory services. Significant variability exists in experiences between services, with a high proportion of participants expressing dissatisfaction with their experience with dementia diagnosis. Strategies to standardise diagnosis of dementia, measure and improve quality of care across all settings are required.CONCLUSIONResults suggest majority of people with dementia are diagnosed outside memory services. Significant variability exists in experiences between services, with a high proportion of participants expressing dissatisfaction with their experience with dementia diagnosis. Strategies to standardise diagnosis of dementia, measure and improve quality of care across all settings are required. |
| Author | Ward, Stephanie Alison Workman, Barbara Ng, Natalie Su Quin Ayton, Darshini |
| Author_xml | – sequence: 1 givenname: Natalie Su Quin orcidid: 0000-0002-1824-2951 surname: Ng fullname: Ng, Natalie Su Quin email: quinatlie@hotmail.com organization: Kingston Centre, Monash Health – sequence: 2 givenname: Darshini surname: Ayton fullname: Ayton, Darshini organization: Monash University – sequence: 3 givenname: Barbara surname: Workman fullname: Workman, Barbara organization: Monash University – sequence: 4 givenname: Stephanie Alison surname: Ward fullname: Ward, Stephanie Alison organization: Monash University |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32359111$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1111/ajag.12455 10.5694/j.1326-5377.2008.tb02140.x 10.1371/journal.pone.0116538 10.1590/S1807-59322011000800012 10.1017/S1041610214000751 10.3233/JAD-150692 10.1186/1471-2296-11-52 10.1186/1472-6963-8-54 10.1007/s12603-010-0022-0 10.1002/(SICI)1099-1166(199908)14:8<626::AID-GPS990>3.0.CO;2-5 10.1111/j.1600-0447.2011.01730.x 10.1371/journal.pone.0079797 10.1071/AH17167 10.1017/S1041610209009156 10.1001/archinte.160.19.2964 10.1017/S1041610213000884 10.1371/journal.pone.0050792 10.5694/mja11.11399 |
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| Copyright | 2020 Royal Australasian College of Physicians This article is protected by copyright. All rights reserved. 2021 Royal Australasian College of Physicians 2020 Royal Australasian College of Physicians. |
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Australian guidelines advocate referral to comprehensive memory services for dementia diagnosis, but many patients may be diagnosed elsewhere.
Aims... Australian guidelines advocate referral to comprehensive memory services for dementia diagnosis, but many patients may be diagnosed elsewhere. This study aimed... BackgroundAustralian guidelines advocate referral to comprehensive memory services for dementia diagnosis, but many patients may be diagnosed elsewhere.AimsTo... Australian guidelines advocate referral to comprehensive memory services for dementia diagnosis, but many patients may be diagnosed... |
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| SubjectTerms | Caregivers carer experience Community health care Dementia Dementia disorders Diagnosis diagnostic service diagnostic setting Hospitals Memory Patients |
| Title | Understanding diagnostic settings and carer experiences for dementia diagnosis in Australia |
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