Perception of Benefits and Risks of Neurocognitive Disorders Diagnosis: A French National Survey

被引:6
|
作者
Garnier-Crussard, Antoine [1 ,2 ]
Vernaudon, Julien [2 ]
Auguste, Nicolas [3 ]
Moutet, Claire [2 ]
Dauphinot, Virginie [2 ]
Krolak-Salmon, Pierre [1 ,2 ,4 ]
机构
[1] Claude Bernard Univ Lyon 1, Villeurbanne, France
[2] Hosp Civils Lyon, Charpennes Hosp, Lyon Inst Elderly, Clin & Res Memory Ctr Lyon, Lyon, France
[3] Clin & Res Memory Ctr St Etienne, St Etienne, France
[4] French Federat Memory Ctr, St Etienne, France
关键词
Dementia; diagnosis; ethical issues; neurocognitive disorders; survey; ALZHEIMERS ASSOCIATION WORKGROUPS; GENERAL-PRACTITIONERS; PRIMARY-CARE; DEMENTIA; DISEASE; DISCLOSURE; RECOMMENDATIONS; SPECIALISTS; GUIDELINES; MANAGEMENT;
D O I
10.3233/JAD-180403
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Background: Neurocognitive disorders (NCD) are underdiagnosed in primary care, mainly because of the misunderstanding of benefits associated with timely diagnosis. Objective: The aim of this study was to explore the benefits and risks of diagnosis in a population of general practitioners (GPs), specialized physicians (SPs), other healthcare professionals (HPs), and informal caregivers (ICs). Methods: A questionnaire was submitted to GPs, SPs, HPs. and ICs. It aimed at evaluating benefits and risks related to NCD diagnosis associated with four prototypical clinical cases at different stages: isolated cognitive complaint/mild NCD, major NCD at mild/moderate stage, moderate stage with behavioral and psychotic symptoms, and severe stage. The concepts of early, timely, and personalized diagnosis were evaluated. Results: A total of 719 completed surveys were collected from 183 GPs, 176 SPs, 281 HPs, and 79 ICs. More than 90% of the participants considered initiating a diagnosis as relevant except at the severe stage. Benefits were superior to risks for all groups and all four cases alike (p < 0.001). Benefits were lower according to GPs and higher for SPs than the other groups at the first two stages (p < 0.001). At the moderate stage, there were few differences between groups. At the severe stage, GPs and SPs claimed it was less relevant to carry out a diagnosis than the other groups (p < 0.001). Risks were higher for ICs and lower for SPs (p < 0.001). The best diagnosis concept was the personalized diagnosis. Conclusion: Benefits appeared more relevant than risks with differences according to the stage of the disease and type of respondents.
引用
收藏
页码:1267 / 1275
页数:9
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