Pathways to care for people with dementia: An international multicentre study.
Journal: International journal of geriatric psychiatry
Volume: 35
Issue: 2
Year of Publication: 2020
Affiliated Institutions:
Department of Neuroscience/DIMSC, Università Politecnica delle Marche, Ancona, Italy.
WHO Collaborating Centre for Mental Health Research and Training, Institute of Psychiatry, Rawalpindi, Pakistan.
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.
Greater Manchester NIHR Clinical Research Network, University of Manchester, UK, Manchester, UK.
Department of Psychiatry, The University of Hong Kong, Hong Kong, China.
CoBTEK lab, Research Memory center, University Côte d'Azur, Nice, France.
Clinic for Mental Disorders, Belgrade, Serbia.
Istanbul Psikiyatri Enstitusu, Istanbul, Turkey.
Division of Old Age Psychiatry, Psychiatric University Hospital Zurich, Zurich, Switzerland.
Department of Medicine and Psychiatry, University of Zaragoza; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain.
Department of Psychiatry, Mind-Medical Research Lab, Korea University, Seoul, Korea.
Alzheimer Pakistan, Lahore, Pakistan.
Department of Psychiatry, Pushpagiri Institute of Medical Sciences, Thiruvalla, Kerala, India.
Department of Geriatrics, Radboud Alzheimer Centre, Donders Institute for Brain Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
Department of Psychological Medicine, National University Hospital, Singapore.
Serbian Academy of Sciences and Arts, Institute of Mental Health, Belgrade, Serbia.
Global Brain Health Institute, Department of Psychiatry, School of Medicine, Trinity College, Dublin, Ireland.
University of Medicine and Pharmacy, Romania.
Human Development Research Foundation, Islamabad, Pakistan.
Old Age Unit, Neuropsychiatric Hospital, Aro, Abeokuta, Nigeria.
Psychiatry Service, Hospital San Jorge, Huesca, Spain.
Department of Neuroscience, University of Bari, Bari, Italy.
Institute of Mental Health, School of Medicine, University of Belgrade, Belgrade, Serbia.
Global Health and Infection Department, Brighton and Sussex Medical School, Brighton; and King's College, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
MentAge, Basel, Switzerland.
Pakistan Institute of Living and Learning, Karachi, Pakistan.
Dementia Care and Research Center, Peking University Institute of Mental Health (Sixth Hospital), Beijing Dementia Key Lab, Beijing, , China.
Association for the Improvement of Mental Health Programmes (AMH), Geneva, Switzerland.
Abstract summary
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.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.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.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.
Authors & Co-authors:
Volpe Umberto U
Amin Hania H
Ayinde Olatunde O OO
Burns Alistair A
Chan Wai Chi WC
David Renaud R
Dejanovic Slavica Djukic SD
Djokic Gorica G
Eraslan Defne D
Fischer Giulia A L GAL
Gracia-García Patricia P
Hamdani Syed Usman SU
Han Changsu C
Jafri Hussain H
Kallivayalil Roy A RA
Kriekaart Roderick Leonard RL
Kua Ee Heok EH
Lam Linda C W LCW
Lecic-Tosevski Dusica D
Leroi Iracema I
Lobo Antonio A
Mihai Adriana A
Minhas Fareed Aslam FA
Mistry Heena H
Ogundele Afolakemi T AT
Olde Rikkert Marcel G M MGM
Olivera Javier J
Palumbo Claudia C
Parker Angela A
Pejuskovic Bojana B
Riese Florian F
Robert Philippe P
Semrau Maya M
Stoppe Gabriela G
Sudhakar Sanu S
Tirintica Andreea Raluca AR
Tofique Sehrish S
Tsoi Chris C
Wolski Lucas L
Yalug Irem I
Wang Huali H
Yu Xin X
Sartorius Norman N
Study Outcome
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