[全科医生面对卢森堡老年患者的记忆问题:对所采用的管理、医生的经验和对具体治疗的看法的研究]。

C Gondoin, F Lévy, D Tirmarche
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摘要

记忆障碍在老年人中很常见。全科医生处于发现和处理这些问题的第一线,许多国家为此发表了建议。对于阿尔茨海默病,目前有四种治疗方法,但没有一种能治愈。一些国家将这些药物的首次处方限制在专科医生,而在卢森堡,每个开业医生都可以开处方,但必须首先询问健康保险。因此,全科医生知道该怎么做是很重要的。我们论文的目的是研究卢森堡全科医生的管理方式,他们对此的感受以及他们对治疗阿尔茨海默病的特定药物的看法。因此,我们向卢森堡的每一位全科医生发了一份调查问卷。我们发现87%的从业人员了解至少一项认知障碍测试。其中一半以上的人检查抑郁症,22.6%的人还增加了自主性评估量表,尽管所有这些测试都是由依赖保险完成的。全科医生参与痴呆症的诊断是很重要的,因为超过一半的人有统计上足够数量的痴呆症患者。大约三分之二的医生确实系统地开始了针对阿尔茨海默病的特定药物。认知障碍的管理对卢森堡的全科医生来说是困难的,特别是披露诊断和管理行为和心理症状。
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[The general practitioner faced with memory problems in the aged patient in Luxembourg: a study of the management employed, the experience of the physicians and the perception of the specific treatment].

Memory impairments are common in elderly. General practitioners are in first line to detect and manage these troubles, for which many countries published recommendations. For Alzheimer disease there are currently four treatments, none of which is healing. Some countries limited the first prescription of those medicines to specialists whereas in Luxembourg, every practitioner is allowed to prescribe them, but has to ask health insurance first. Consequently, it is important that general practitioners know what to do. The aim of our paper is to study the management done by the general practitioners in Luxembourg, the way they feel about it and the way they see the specific medicines for Alzheimer disease. Therefore, we have sent a questionnaire to every general practitioner in Luxembourg. We found that 87% of the practitioners realize at least one cognitive impairment test. More than half of them check for depression and 22.6% also add an autonomy assessment scale, even though all these tests are done by the dependence insurance. The involvement of general practitioners in the diagnosis of dementia is important as more than half of them have a statistically adequate number of demented patients. About two third of the practitioners do systematically start a specific medicine for Alzheimer disease. The management of cognitive impairment is difficult for general practitioners of Luxembourg, particularly the disclosure of diagnosis and management of behavioural and psychological symptoms.

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