初级保健中检测认知障碍（DetectCID）的经验教训。
Lessons from Detecting Cognitive Impairment Including Dementia (DetectCID) in Primary Care.
机构信息
Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, USA.
Department of Humanities & Social Sciences, University of California, San Francisco, San Francisco, CA, USA.
出版信息
J Alzheimers Dis. 2022;86(2):655-665. doi: 10.3233/JAD-215106.
BACKGROUND
Cognitive impairment, including dementia, is frequently under-detected in primary care. The Consortium for Detecting Cognitive Impairment, including Dementia (DetectCID) convenes three multidisciplinary teams that are testing novel paradigms to improve the frequency and quality of patient evaluations for detecting cognitive impairment in primary care and appropriate follow-up.
OBJECTIVE
Our objective was to characterize the three paradigms, including similarities and differences, and to identify common key lessons from implementation.
METHODS
A qualitative evaluation study with dementia specialists who were implementing the detection paradigms. Data was analyzed using content analysis.
RESULTS
We identified core components of each paradigm. Key lessons emphasized the importance of engaging primary care teams, enabling primary care providers to diagnose cognitive disorders and provide ongoing care support, integrating with the electronic health record, and ensuring that paradigms address the needs of diverse populations.
CONCLUSION
Approaches are needed that address the arc of care from identifying a concern to post-diagnostic management, are efficient and adaptable to primary care workflows, and address a diverse aging population. Our work highlights approaches to partnering with primary care that could be useful across specialties and paves the way for developing future paradigms that improve differential diagnosis of symptomatic cognitive impairment, identifying not only its presence but also its specific syndrome or etiology.
背景
认知障碍，包括痴呆，在初级保健中经常未被发现。认知障碍包括痴呆检测联合会（DetectCID）召集了三个多学科团队，正在测试新的范式，以提高初级保健中检测认知障碍的频率和质量，并进行适当的随访。
目的
我们的目的是描述这三种范式，包括相似点和不同点，并确定从实施中得出的共同关键经验。
方法
对正在实施检测范式的痴呆专家进行定性评估研究。使用内容分析法对数据进行分析。
结果
我们确定了每个范式的核心组成部分。关键经验强调了让初级保健团队参与的重要性，使初级保健提供者能够诊断认知障碍并提供持续的护理支持，与电子健康记录集成，并确保范式满足不同人群的需求。
结论
需要采取措施来解决从发现问题到诊断后管理的整个护理过程，这些措施要高效，适应初级保健工作流程，并针对多样化的老年人口。我们的工作强调了与初级保健合作的方法，这些方法可能对其他专业领域也有用，并为开发未来的范式铺平了道路，这些范式可以改善有症状的认知障碍的鉴别诊断，不仅可以识别其存在，还可以识别其特定的综合征或病因。
Zotero 插件