Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Department of Geriatrics and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Psychogeriatrics. 2022 Sep;22(5):707-717. doi: 10.1111/psyg.12874. Epub 2022 Jul 10.
Timely recognition and treatment of neuropsychiatric symptoms (NPS) in Alzheimer's disease (AD) dementia may improve quality of life, reduce caregiver burden, and delay disease progression. However, management of NPS in early AD dementia remains challenging. To date, little is known about the specific challenges for memory clinic-based physicians. The aims of this qualitative study were to obtain insights regarding the recognition and treatment of NPS in AD dementia in the memory clinic, to identify challenges experienced by physicians while managing NPS, and to examine the attitudes of memory clinic physicians on the role of the memory clinic in the care for NPS in early AD dementia.
Semi-structured interviews were conducted with 13 physicians working at a memory clinic in the Netherlands (n = 7 neurologist, n = 6 geriatrician, 46% female). The data were analyzed by two independent researchers using thematic analysis.
We observed large variation among Dutch memory clinic physicians regarding care practices, expertise, and attitudes on the role of the memory clinic considering NPS in AD dementia. The most prominent challenges that memory clinic physicians experienced while managing NPS included that the outpatient setting complicates the recognition and treatment of NPS, a lack of experience, knowledge, and/or resources to adequately apply non-pharmacological interventions, and a lack of consensus among physicians on the role of the memory clinic in NPS recognition and management.
We identified challenges that need to be addressed to improve the early recognition and adequate management of NPS in AD dementia at the memory clinic.
及时识别和治疗阿尔茨海默病（AD）痴呆患者的神经精神症状（NPS）可以改善生活质量、减轻照顾者负担并延缓疾病进展。然而，早期 AD 痴呆患者 NPS 的管理仍然具有挑战性。迄今为止，我们对记忆诊所医生面临的具体挑战知之甚少。本定性研究的目的是深入了解记忆诊所中 AD 痴呆患者 NPS 的识别和治疗情况，确定医生在管理 NPS 时遇到的挑战，并研究记忆诊所医生对记忆诊所在早期 AD 痴呆患者 NPS 护理中的作用的态度。
对荷兰一家记忆诊所的 13 名医生（7 名神经科医生，6 名老年病医生，女性占 46%）进行了半结构化访谈。两位独立研究人员使用主题分析对数据进行分析。
我们观察到荷兰记忆诊所医生在 AD 痴呆患者 NPS 的护理实践、专业知识和态度方面存在很大差异。记忆诊所医生在管理 NPS 时遇到的最突出的挑战包括：门诊环境使 NPS 的识别和治疗变得复杂，缺乏经验、知识和/或资源来充分应用非药物干预措施，以及医生对记忆诊所在 NPS 识别和管理中的作用缺乏共识。
我们确定了需要解决的挑战，以改善记忆诊所中 AD 痴呆患者 NPS 的早期识别和适当管理。
