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Clinical practice patterns of generalists and specialists in Alzheimer's disease: What are the differences, and what difference do they make?

Lookup NU author(s): Professor Dame Louise Robinson

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Abstract

Optimising the roles played by both generalists and specialists in the diagnosis and treatment of Alzheimer's disease (AD) could have a major impact on the quality and cost of patient care. Therefore, one aim of the IMPACT survey was to characterise the similarities and differences between these 2 categories of physicians, in 5 different European countries, across a number of domains relevant to the medical care of people at risk for AD and those with the disease. Physician respondents comprised 250 generalists and 250 specialists from 5 European countries-France, Germany, Italy, Spain, and the United Kingdom. A substantial majority of generalists were either general practitioners or family physicians; the majority of specialists were neurologists. In April and May 2009, physician respondents completed a 30-minute, Web-based questionnaire during which they were presented with a number of multiple-choice-type questions concerning their knowledge of AD, approach to diagnosis and treatment of AD and experience of providing care for people with dementia. Generalists reported that 45% of their AD patients had mild symptoms at the initial visit compared with 60% for specialists (P < 0.001). Specialists claimed that they diagnose patients with AD themselves in 65% of cases versus 33% for generalists (P < 0.001). The main prescription treatment options employed were AD-specific medication (90%) and medication for mood or behaviour (78%). A similar percentage of generalists and specialists (77% and 75%) initiate drug treatment within 1 month of diagnosis. Overall, there were more similarities than differences between specialists and generalists regarding a broad spectrum of issues relating to AD; differences between countries appear to be greater than differences between physician groups.

Publication metadata

Author(s): Robinson L, Vellas B, Knox S, Lins K

Publication type: Article

Publication status: Published

Journal: Journal of Nutrition, Health and Aging

Year: 2010

Volume: 14

Issue: 7

Pages: 545-552

Print publication date: 24/09/2010

ISSN (print): 1279-7707

ISSN (electronic): 1760-4788

Publisher: Editions SERDI

URL: http://dx.doi.org/10.1007/s12603-010-0266-8

DOI: 10.1007/s12603-010-0266-8

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