Olde Rikkert Marcel G M, Lemstra Evelien W, Verhey Frans R J
UMC St Radboud, Radboud Alzheimer Centrum, Nijmegen, the Netherlands.
Ned Tijdschr Geneeskd. 2012;156(49):A5554.
The third revision of the Dutch College of General Practitioners' practice guideline 'Dementia' is a major improvement and stimulates the general practitioner by providing concrete advice on stepped care in dementia diagnostics and organizing care management in order to obtain improvement in the quality and realization of dementia care in the primary care setting. However, this practice guideline does not address more effective and efficient dementia care by collaboration between primary and secondary care as it discourages the prescription of cholinesterase inhibitors and recommends limiting further diagnostic procedures to patients in whom a treatable condition is likely. Although, this new practice guideline strengthens the central role of the general practitioner in Dutch dementia care, this role would be further reinforced if general practitioners were to adopt integrated diagnostics of dementia and relevant additional diseases burden as the starting point.
荷兰全科医生学院《痴呆症》实践指南的第三次修订有了重大改进，通过提供关于痴呆症诊断分级护理以及组织护理管理的具体建议，激励全科医生在初级保健环境中提高痴呆症护理的质量和落实情况。然而，该实践指南未涉及初级和二级护理协作实现更有效和高效的痴呆症护理，因为它不鼓励开具胆碱酯酶抑制剂处方，并建议将进一步的诊断程序限制在可能患有可治疗疾病的患者身上。尽管这项新的实践指南强化了全科医生在荷兰痴呆症护理中的核心作用，但如果全科医生将痴呆症及相关附加疾病负担的综合诊断作为出发点，这一作用将得到进一步加强。
