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初级保健提供者和痴呆症专家使用血浆阿尔茨海默病生物标志物的决定因素。

Determinants of Plasma Alzheimer's Disease Biomarker Use by Primary Care Providers and Dementia Specialists.

机构信息

University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA. kyra.o'

University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.

出版信息

J Gen Intern Med. 2024 Jul;39(9):1713-1720. doi: 10.1007/s11606-023-08583-9. Epub 2024 Jan 2.

Abstract

BACKGROUND

The efficiencies of plasma Alzheimer's disease (AD) biomarkers could facilitate early AD diagnosis. Unfortunately, limited knowledge exists about whether and how they would be used by clinicians.

OBJECTIVE

To identify and compare determinants of plasma AD biomarker use reported by primary care providers and dementia specialists.

DESIGN

Semi-structured interviews with clinicians organized using Rogers' Diffusion of Innovations theory and analyzed using an iterative coding approach.

PARTICIPANTS

The subjects were internal and family medicine, neurology, and geriatrics providers with varying degrees of expertise in dementia diagnosis and care.

MAIN MEASURES

Factors influencing a clinician's decision to use or not use plasma AD biomarkers in clinical practice.

KEY RESULTS

We interviewed 30 clinicians (16 family or internal medicine providers, 8 geriatricians, and 6 neurologists). Fifteen were dementia specialists. Hesitance to use plasma AD biomarkers was due to perceived lack of effective treatments for AD, limited access to supports, and stigma. Plasma AD biomarkers would be more readily adopted by clinicians with dementia expertise.

CONCLUSIONS

Several factors will influence clinical use of plasma AD biomarkers. Some of them may inform the design of interventions to promote the effective and appropriate clinical translation of these tests.

摘要

背景

血浆阿尔茨海默病(AD)生物标志物的效率可以促进 AD 的早期诊断。不幸的是,关于临床医生是否以及如何使用它们的知识有限。

目的

确定并比较初级保健提供者和痴呆症专家报告的血浆 AD 生物标志物使用的决定因素。

设计

使用罗杰斯创新扩散理论组织的半结构化访谈,并使用迭代编码方法进行分析。

参与者

研究对象为具有不同痴呆症诊断和护理专业知识的内科和家庭医学、神经病学和老年医学提供者。

主要措施

影响临床医生在临床实践中使用或不使用血浆 AD 生物标志物的因素。

主要结果

我们采访了 30 名临床医生(16 名家庭或内科医生、8 名老年病学家和 6 名神经科医生)。其中 15 名为痴呆症专家。由于认为 AD 缺乏有效治疗方法、获取支持有限以及污名化,临床医生对使用血浆 AD 生物标志物犹豫不决。具有痴呆症专业知识的临床医生更愿意采用血浆 AD 生物标志物。

结论

有几个因素会影响血浆 AD 生物标志物的临床应用。其中一些因素可能为促进这些测试的有效和适当的临床转化的干预措施的设计提供信息。

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