Systematic review investigating multi-disciplinary team approaches to screening and early diagnosis of dementia in primary care: what are the positive and negative effects and who should deliver it?

Toby Smith, Jane Cross, Fiona Poland, Abbey Brookes, Ian Maidment, Bridget Penhale, Ken Laidlaw, Chris Fox

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Primary care services frequently provide the initial contact between people with dementia and health service providers. Early diagnosis and screening programmes have been suggested as a possible strategy to improve the identification of such individuals and treatment and planning health and social care support.

OBJECTIVE: To determine what early diagnostic and screening programmes have been adopted in primary care practice, to explore who should deliver these and to determine the possible positive and negative effects of an early diagnostic and screening programme for people with dementia in primary care.

METHODS: A systematic review of the literature was undertaken using published and unpublished research databases. All papers answering our research objectives were included. A narrative analysis of the literature was undertaken, with the CASP tools used appropriately to assess study quality.

RESULTS: Thirty-three papers were identified of moderate to high quality. The limited therapeutic options for those diagnosed with dementia means that even if such a programme were instigated, the clinical value remains questionable. Furthermore accuracy of the diagnosis remains difficult to assess due to poor evidence and this raises questions regarding whether people could be over- or under-diagnosed. Given the negative social and psychological consequences of such a diagnosis, this could be devastating for individuals.

CONCLUSIONS: Early diagnostic and screening programme have not been widely adopted into primary care. Until there is rigorous evidence assessing the clinical and cost-effectiveness of such programmes, there remains insufficient evidence to support the adoption of these programmes in practice.

LanguageEnglish
Pages5-17
Number of pages13
JournalCurrent Alzheimer Research
Volume15
Issue number1
Early online date7 Sep 2017
DOIs
Publication statusPublished - 7 Sep 2017

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Dementia
Early Diagnosis
Primary Health Care
Research
Health Services
Cost-Benefit Analysis
Databases
Psychology
Delivery of Health Care
Therapeutics

Bibliographical note

The published manuscript is available at EurekaSelect via http://www.eurekaselect.com/openurl/content.php?genre=article&doi=10.2174/1567205014666170908094931

Keywords

  • Diagnostic
  • Population screening
  • cognitive impairment;
  • experiences
  • general practice
  • community services

Cite this

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title = "Systematic review investigating multi-disciplinary team approaches to screening and early diagnosis of dementia in primary care: what are the positive and negative effects and who should deliver it?",
abstract = "BACKGROUND: Primary care services frequently provide the initial contact between people with dementia and health service providers. Early diagnosis and screening programmes have been suggested as a possible strategy to improve the identification of such individuals and treatment and planning health and social care support.OBJECTIVE: To determine what early diagnostic and screening programmes have been adopted in primary care practice, to explore who should deliver these and to determine the possible positive and negative effects of an early diagnostic and screening programme for people with dementia in primary care.METHODS: A systematic review of the literature was undertaken using published and unpublished research databases. All papers answering our research objectives were included. A narrative analysis of the literature was undertaken, with the CASP tools used appropriately to assess study quality.RESULTS: Thirty-three papers were identified of moderate to high quality. The limited therapeutic options for those diagnosed with dementia means that even if such a programme were instigated, the clinical value remains questionable. Furthermore accuracy of the diagnosis remains difficult to assess due to poor evidence and this raises questions regarding whether people could be over- or under-diagnosed. Given the negative social and psychological consequences of such a diagnosis, this could be devastating for individuals.CONCLUSIONS: Early diagnostic and screening programme have not been widely adopted into primary care. Until there is rigorous evidence assessing the clinical and cost-effectiveness of such programmes, there remains insufficient evidence to support the adoption of these programmes in practice.",
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Systematic review investigating multi-disciplinary team approaches to screening and early diagnosis of dementia in primary care : what are the positive and negative effects and who should deliver it? / Smith, Toby; Cross, Jane; Poland, Fiona; Brookes, Abbey; Maidment, Ian; Penhale, Bridget; Laidlaw, Ken; Fox, Chris.

In: Current Alzheimer Research, Vol. 15, No. 1, 07.09.2017, p. 5-17.

Research output: Contribution to journalArticle

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AU - Smith, Toby

AU - Cross, Jane

AU - Poland, Fiona

AU - Brookes, Abbey

AU - Maidment, Ian

AU - Penhale, Bridget

AU - Laidlaw, Ken

AU - Fox, Chris

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N2 - BACKGROUND: Primary care services frequently provide the initial contact between people with dementia and health service providers. Early diagnosis and screening programmes have been suggested as a possible strategy to improve the identification of such individuals and treatment and planning health and social care support.OBJECTIVE: To determine what early diagnostic and screening programmes have been adopted in primary care practice, to explore who should deliver these and to determine the possible positive and negative effects of an early diagnostic and screening programme for people with dementia in primary care.METHODS: A systematic review of the literature was undertaken using published and unpublished research databases. All papers answering our research objectives were included. A narrative analysis of the literature was undertaken, with the CASP tools used appropriately to assess study quality.RESULTS: Thirty-three papers were identified of moderate to high quality. The limited therapeutic options for those diagnosed with dementia means that even if such a programme were instigated, the clinical value remains questionable. Furthermore accuracy of the diagnosis remains difficult to assess due to poor evidence and this raises questions regarding whether people could be over- or under-diagnosed. Given the negative social and psychological consequences of such a diagnosis, this could be devastating for individuals.CONCLUSIONS: Early diagnostic and screening programme have not been widely adopted into primary care. Until there is rigorous evidence assessing the clinical and cost-effectiveness of such programmes, there remains insufficient evidence to support the adoption of these programmes in practice.

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