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全科医疗中的痴呆症诊断与转诊:爱尔兰全科医生的代表性调查

Dementia Diagnosis and Referral in General Practice: A Representative Survey of Irish General Practitioners.

作者信息

Dyer A H, Foley T, O’Shea B, Kennelly S P

机构信息

School of Medicine, Trinity College Dublin, Ireland

Department of General Practice, University College Cork, Ireland

出版信息

Ir Med J. 2018 Apr 19;111(4):735.

Abstract

Aims Most of those with a memory problem or concern over cognition present to their General Practitioner (GP) in the first instance. Despite this, the current diagnostic and referral patterns of Irish GPs remains unclear. Methods A survey was distributed to three separate cohorts of GPs (n=692) Results Ninety-Five (14%) responded. Most personally diagnose 1-3 (69%; 65/95) or 4-6 (21%; 20/95) patients with dementia per year. Two-thirds (62%; 59/95) refer >80% of those with possible dementia for further assessment/support, most commonly to support/clarify a diagnosis (71%; 67/95) and most frequently to a geriatrician (79%; 75/95). In half of cases (51%; 48/95), referral is to a professional working as part of an established memory clinic. One-fifth reported receiving dementia-specific postgraduate training (19%; 18/95) and over four-fifths (82%; 78/95) would welcome further training. Discussion Further attention to the ongoing establishment of memory clinic services and dedicated referral pathways, as well as increasing emphasis on dementia assessment and diagnosis in medical curricula, is warranted.

摘要

目的 大多数有记忆问题或认知方面担忧的人首先会去看他们的全科医生(GP)。尽管如此,爱尔兰全科医生目前的诊断和转诊模式仍不明确。方法 对三组不同的全科医生群体(n = 692)进行了一项调查。结果 九十五名(14%)做出了回应。大多数人每年亲自诊断1 - 3名(69%;65/95)或4 - 6名(21%;20/95)痴呆患者。三分之二(62%;59/95)将80%以上可能患有痴呆症的患者转诊进行进一步评估/支持,最常见的是为了支持/明确诊断(71%;67/95),最常转诊给老年病专家(79%;75/95)。在一半的病例中(51%;48/95),转诊给作为既定记忆诊所一部分工作的专业人员。五分之一的人报告接受过痴呆症专项研究生培训(19%;18/95),超过五分之四(82%;78/95)的人欢迎进一步培训。讨论 有必要进一步关注记忆诊所服务的持续建立和专门的转诊途径,以及在医学课程中更加重视痴呆症评估和诊断。

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