On 2 December, Dr Agnetha Fruijtier, Prof. Ellen Smets and colleagues published an article in Alzheimers & Dementia: Translational Research and Clinical Interventions, in which they show that diagnostic consultations in memory clinics do not always address all the key informational topics for patients.
The ABIDE Delphi study conducted with patients, care partners and clinicians identified 25 informational topics of particular importance and relevance for these groups during the initial diagnostic consultation. These topics include information on diagnostic testing, the test results themselves, diagnosis and prognosis, and also practical implications of the diagnosis. In their study, Dr Fruijtier and colleagues sought to evaluate how these topics are addressed in the real-world setting, who initiates discussion of specific topics, and at which point this occurs during diagnostic consultations.
They analysed the audio recordings of diagnostic consultations performed with 71 patients seen by 32 clinicians, showing that on average, 12 of the 25 important informational topics were addressed per patient. Some topics were addressed very rarely (e.g PET scan results; 2/71 consultations) while others were addressed very frequently (e.g Next appointment date and time: 70/71 consultations). Topics in the category “Information and Diagnosis and Prognosis”, which were deemed most relevant by patients and care partners but not by clinicians, were addressed least frequently, and not at all in 50% of the consultations. In addition, patients and/or care partners initiated topic discussion much less frequently than clinicians (10%). When they did, they often enquired about one of the more rarely-addressed topics. To improve the range of topics addressed in diagnostic consultations and increase patient/care partner-directed discussion, the authors recommend providing the topic list to patients and care partners beforehand, to allow them to prepare for the consultation in advance.
https://alz-journals.onlinelibrary.wiley.com/doi/epdf/10.1002/trc2.12113