Pathways to care for people for dementia: an international multi-centre study

Volpe, Umberto, Amin, H, Ayinde, Olatunde O, Burns, Alistair, Chan, Wai Chi, David, Renaud, Deianovic, Slavica Djukic, Dokii, Gorica, Eraslan, Defne, Fischer, Giulia A L, Gracia-Garcia, Patricia, Hamdani, Syed Usman, Han, Cchangsu, Jafri, Hussain, Semrau, Maya and others, . (2019) Pathways to care for people for dementia: an international multi-centre study. International Journal of Geriatric Psychiatry. pp. 1-27. ISSN 0885-6230

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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 centers 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, 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.

Item Type: Article
Schools and Departments: Brighton and Sussex Medical School > Brighton and Sussex Medical School
Brighton and Sussex Medical School > Global Health and Infection
Research Centres and Groups: Brighton and Sussex Centre for Global Health Research
Subjects: R Medicine
R Medicine > RZ Other systems of medicine
Depositing User: Deborah Miller
Date Deposited: 02 Oct 2019 09:04
Last Modified: 28 Oct 2020 02:00

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