Lessons from Detecting Cognitive Impairment Including Dementia (DetectCID) in Primary Care.
Lessons from Detecting Cognitive Impairment Including Dementia (DetectCID) in Primary Care.
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DOI：
10.3233/jad-215106
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发表时间：
2022
影响因子：
4
通讯作者：
Possin, Katherine L.
中科院分区：
文献类型：
--
作者：
Sideman, Alissa Bernstein;Chalmer, Rachel;Ayers, Emmeline;Gershon, Richard;Verghese, Joe;Wolf, Michael;Ansari, Asif;Arvanitis, Marina;Bui, Nhat;Chen, Pei;Chodos, Anna;Corriveau, Roderick;Curtis, Laura;Ehrlich, Amy R.;Farias, Sarah E. Tomaszewski;Goode, Collette;Hill-Sakurai, Laura;Nowinski, Cindy J.;Premkumar, Mukund;Rankin, Katherine P.;Ritchie, Christine S.;Tsoy, Elena;Weiss, Erica;Possin, Katherine L.
关键词：
初级保健中经常未能发现包括痴呆症在内的认知障碍。包括痴呆症在内的认知障碍检测联盟 (DetectCID) 召集了三个多学科团队，正在测试新的范式，以提高患者评估的频率和质量，以检测初级保健中的认知障碍和适当的随访。我们的目标是描述这三种范式的特征，包括相似点和差异，并从实施中找出共同的关键经验教训。与实施检测范例的痴呆症专家进行的定性评估研究。使用内容分析来分析数据。我们确定了每个范例的核心组成部分。主要经验强调了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，与电子健康记录相结合，并确保范例满足不同人群的需求。需要采取一些方法来解决从识别问题到诊断后管理的护理弧线，高效且适应初级护理工作流程，并解决不同的老龄化人群问题。我们的工作重点介绍了与初级护理合作的方法，这些方法可能对跨专业有用，并为开发未来的范式铺平道路，以改善症状性认知障碍的鉴别诊断，不仅识别其存在，而且识别其具体情况 综合征或病因。
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. Our objective was to characterize the three paradigms, including similarities and differences, and to identify common key lessons from implementation. A qualitative evaluation study with dementia specialists who were implementing the detection paradigms. Data was analyzed using content analysis. 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. Approaches are needed that address the arc of care from identifying a concern to post-diagnostic management, areefficientandadaptabletoprimarycareworkflows,andaddressadiverseagingpopulation.Ourworkhighlightsapproaches 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.