Wednesday, 20 August 2003
This presentation is part of : Public Policy: Different Venues but Similar Problems Around the World

S059-001 New Advances to Timely Dementia Diagnosis in EU Countries: A Quality Improvement Approach

Myrra MJFJ Vernooij-Dassen, Alzheimer Centre Nijmegen/Centre for Quality of Care Research, University Medical Centre Nijmegen, Nijmegen, Netherlands, Steve Iliffe, Royal Free &UCL Medical School, London, England, Esme Moniz-Cook, School of Medicine, University of Hull, Hull, England, and Jan DeLepeleire, General Practice, Catholic University of Leuven, Lint, Belgium.

Objective: The recognition and response to dementia is often delayed. Late diagnosis reduces the opportunities for early medical and psychosocial interventions. This European Union funded project aims to advance knowledge and practice in timely diagnosis of dementia through a new systematic quality improvement programme (the DIADEM project). This program starts with the investigation of obstacles and facilitators to diagnosis, followed by efforts to address obstacles by making optimal use of the facilitators. The first question for the DIADEM project was: What are the obstacles and facilitators to making a diagnosis of dementia in EU countries?

Design: Focus groups were used to elicit obstacles and facilitators.

Materials and Methods: The participants were 22 experts in dementia care and research, including general practitioners, from 9 EU countries. Each focus group consisted of 11 participants and was facilitated by a practitioner experienced in group work. The aim was to maximize the interaction between group members and to foster the generation and exploration of new ideas and perspectives. The data were analyzed by qualitative content analysis.

Results: A key obstacle to timely diagnosis was the stigma associated with dementia, which may be perceived by patients, carers and professionals. There are differences between countries in the degree of stigmatization and its effects and the effort to reduce this. Furthermore, professionalsx feelings of having nothing to offer, the lack of guidelines to diagnose dementia in several EU countries and diagnostic uncertainty also contribute to late diagnosis. However, the facilitators that were identified suggest that there is scope to address these obstacles: availability of guidelines in some other EU countries which can be translated, effective support programs, including IT cognitive stimulation, and efforts in some countries to diminish the stigma and to integrate dementia into the society by Alzheimer cafes.

Conclusion: Consideration of actual obstacles (within a xnational circumstancesx framework) and potential solutions reveals new pan-European methods to promote timely diagnosis. The obstacles that were identified suggest that cultural problems such as stigmatisation negatively influence the use of facilitators like diagnostic guidelines and psychosocial interventions. A pan-European strategy for promoting timely diagnosis which can begin within primary care is being made, based on these results.

The abstract has been submitted on behalf of the Interdem group. This is an European study group on early diagnosis and timely interventions in dementia.

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