Pathways to care for people with dementia: An international multicentre study
- 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-Garcia, Patricia; Hamdani, Syed Usman; Han, Changsu; Jafri, Hussain; Kallivayalil, Roy A.; Kriekaart, R.; Kua, Ee Heok; Lam, Linda C. W.; Lecic-Tosevski, Dusica; Leroi, Iracema; Lobo, Antonio; Mihai, Adriana; Minhas, Fareed Aslam; Mistry, Heena; Ogundele, Afolakemi T.; Rikkert, Marcel G. M. Olde; 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
- Issue Date
- dementia; geriatric psychiatry; health care policy; outcome; pathways to care; time to diagnosis
- International Journal of Geriatric Psychiatry, v.35, no.2, pp.163 - 173
- Journal Title
- International Journal of Geriatric Psychiatry
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- End Page
- 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.
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- 2. Clinical Science > Department of Psychiatry > 1. Journal Articles
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