Primary Care Education Consortium, Winnsboro, SC, USA.
Banner Alzheimer's Institute, University of Arizona College of Medicine, Phoenix, AZ, USA.
Postgrad Med. 2023 Jun;135(5):530-538. doi: 10.1080/00325481.2023.2217025. Epub 2023 May 29.
Early diagnosis of mild cognitive impairment (MCI) and mild Alzheimer's disease (AD) dementia is crucial for effective disease management and optimizing patient outcomes. We sought to better understand the MCI and mild AD dementia medical journey from the perspective of patients, care partners, and physicians.
We conducted online surveys in the United States among patients/care partners and physicians in 2021.
103 patients with all-cause MCI or mild AD dementia aged 46-90 years, 150 care partners for someone with all-cause MCI or mild AD dementia, and 301 physicians (101 of which were primary care physicians, [PCPs]) completed surveys. Most patient/care partners reported that experiencing forgetfulness (71%) and short-term memory loss (68%) occurred before talking to a healthcare professional. Most patients (73%) followed a common medical journey, in which the initial discussion with a PCP took place 15 months after symptom onset. However, only 33% and 39% were diagnosed and treated by a PCP, respectively. Most (74%) PCPs viewed themselves as coordinators of care for their patients with MCI and mild AD dementia. Over one-third (37%) of patients/care partners viewed PCPs as the care coordinator.
PCPs play a vital role in the timely diagnosis and treatment of MCI and mild AD dementia but often are not considered the care coordinator. For the majority of patients, the initial discussion with a PCP took place 15 months after symptom onset; therefore, it is important to educate patients/care partners and PCPs on MCI and AD risk factors, early symptom recognition, and the need for early diagnosis and treatment. PCPs could improve patient care and outcomes by building their understanding of the need for early AD diagnosis and treatment and improving the efficiency of the patient medical journey by serving as coordinators of care.
轻度认知障碍(MCI)和轻度阿尔茨海默病(AD)痴呆的早期诊断对于有效管理疾病和优化患者预后至关重要。我们旨在从患者、照护者和医生的角度更好地了解 MCI 和轻度 AD 痴呆的医疗历程。
我们于 2021 年在美国开展了一项针对患者/照护者和医生的在线调查。
103 名患有各种病因的 MCI 或轻度 AD 痴呆的患者(年龄 46-90 岁)、150 名照护者和 301 名医生(其中 101 名为初级保健医生 [PCP])完成了调查。大多数患者/照护者报告说,出现健忘(71%)和短期记忆丧失(68%)的情况是在与医疗保健专业人员交谈之前。大多数患者(73%)遵循常见的医疗历程,即初始讨论是在症状出现后 15 个月与 PCP 进行的。然而,仅有 33%和 39%的患者分别由 PCP 进行了诊断和治疗。大多数(74%)的 PCP 认为自己是 MCI 和轻度 AD 痴呆患者的护理协调者。超过三分之一(37%)的患者/照护者认为 PCP 是护理协调者。
PCP 在及时诊断和治疗 MCI 和轻度 AD 痴呆方面发挥着至关重要的作用,但通常不被视为护理协调者。对于大多数患者,与 PCP 的初始讨论是在症状出现后 15 个月进行的;因此,重要的是要向患者/照护者和 PCP 教育 MCI 和 AD 危险因素、早期症状识别以及早期诊断和治疗的必要性。PCP 可以通过了解早期 AD 诊断和治疗的必要性、提高患者医疗历程的效率(充当护理协调者)来改善患者护理和结局。