Diagnostic information in GP referral letters to a memory clinic: a cohort study.

IF 2.5 Q2 PRIMARY HEALTH CARE BJGP Open Pub Date : 2024-08-21 DOI:10.3399/BJGPO.2024.0065
Demi Ronner, Dorien Oostra, Jurgen Claassen, Edo Richard, Marieke Perry
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Abstract

Background: Dementia diagnostics can often be performed in primary care, yet older persons with memory complaints are frequently referred to memory clinics (MCs).

Aim: To compare diagnostic information in general practitioner (GP) referral letters of patients with and without an eventual dementia diagnosis.

Design & setting: Retrospective cohort study in a Dutch academic geriatric MC.

Method: We collected electronic health record (EHR) data of consecutive patients aged≥65 referred by their GP between 2016-2020. EHR data included patient characteristics, diagnostic information in referral letters, ancillary investigations performed at the MC, and established diagnoses. Chi-square tests were applied to compare groups.

Results: Of 651 patients included, the average age was 78.0 (SD: 6.8), and 348 (53.5%) were diagnosed with dementia. Most people with dementia were diagnosed without ancillary investigations (235/348, 67.5%). In GP referral letters of people with dementia compared with people without dementia, a collateral history, any physical examination, a differential diagnosis including dementia, an MMSE score, interference with daily functioning, and decline from previous levels of functioning were mentioned more often. Furthermore, the more diagnostic criteria mentioned in the referral letter, the more often dementia was diagnosed at the MC (no criteria: 35.4%, one criterion: 47.3%, two criteria: 53.4%, three criteria: 69.9%, four or five criteria: 83.3%).

Conclusion: GPs often correctly mention diagnostic information and dementia criteria in referral letters of people with dementia, and they are often diagnosed without ancillary investigations. This suggests that referral is often unnecessary, and GPs can be empowered to diagnose dementia themselves.

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记忆诊所全科医生转诊信中的诊断信息:一项队列研究。
背景:目的:比较全科医生(GP)转诊信中最终诊断出痴呆症和未诊断出痴呆症的患者的诊断信息:荷兰一家老年医学学术委员会的回顾性队列研究:我们收集了2016-2020年间由全科医生转诊的年龄≥65岁的连续患者的电子健康记录(EHR)数据。电子病历数据包括患者特征、转诊信中的诊断信息、在医疗中心进行的辅助检查和确诊。采用卡方检验对各组进行比较:在纳入的 651 名患者中,平均年龄为 78.0 岁(标准差:6.8),348 人(53.5%)被诊断为痴呆症。大多数痴呆症患者在确诊时未进行辅助检查(235/348,67.5%)。与非痴呆症患者相比,在痴呆症患者的全科医生转介信中,附带病史、任何体格检查、包括痴呆症在内的鉴别诊断、MMSE评分、对日常功能的干扰以及功能从以前的水平下降被提及的频率更高。此外,转介信中提及的诊断标准越多,在管委会诊断出痴呆症的频率就越高(无标准:35.4%;有标准:1.5%):无标准:35.4%;有一个标准:47.3%;有两个标准:35.4无标准:35.4%;有一个标准:47.3%;有两个标准:53.4%;有三个标准:47.353.4%,三项标准:69.9%,四项或五项标准:53.4没有标准:35.4%;一个标准:47.3%;两个标准:53.4%;三个标准:69.9%;四个或五个标准:83.3%):结论结论:全科医生通常会在痴呆症患者的转诊信中正确提及诊断信息和痴呆症标准,而且这些患者通常无需辅助检查即可确诊。这表明转诊往往是不必要的,全科医生可以自己诊断痴呆症。
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来源期刊
BJGP Open
BJGP Open Medicine-Family Practice
CiteScore
5.00
自引率
0.00%
发文量
181
审稿时长
22 weeks
期刊最新文献
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