Disclosure of diagnosis of Alzheimer's disease in French general practice.
Most practitioners find disclosing the diagnosis of Alzheimer s disease (AD) to an individual with dementia very difficult. Literature results show a wide variability in attitudes and clinicalpractice, and diagnosis seems to be more often disclosed to caregivers than to patients. The objective of this study was to examine whether and how diagnosis of AD is disclosed in French general practice and which issues are addressed with the patient. A questionnaire was sent via mail to 1,629 general practitioners (GPs), 1,105 belonging to the Sentinel's network and 524 specially recruited doctors practicing in the Rhône-Alpes region. A total of 631 questionnaires were returned (response rate, 39 percent), of which 616 were eligible for analysis. Twenty-eight percent of GPs reported having disclosed diagnosis to the patient (25 percent mentioned "Alzheimer's disease"), whereas 88 percent considered it their role to announce the diagnosis to the patient. Regarding the type of information provided to the patient, only 25 percent discussed the nature of the illness, 23 percent behavioral problems, and 47 percent depression, mainly for psychological reasons (63 percent). Stress was discussed with 79 percent of the caregivers. We concluded that GPs do not discuss the consquences of AD and symptoms (e.g., behavioral disorders) with patients, mainly for psychological reasons, whereas they have a less-reluctant attitude toward caregivers. As the GP has the weighty task of providing ropriate community care and psychological support to the patient, it is of utmost importance to reflect on how disclosure of diagnosis can be facilitated.
Cantegreil-Kallen
Inge
I
Department of Geriatrics, Broca Hospital, Paris, France.
Turbelin
Clément
C
Olaya
Emile
E
Blanchon
Thierry
T
Moulin
Florence
F
Rigaud
Anne-Sophie
AS
Flahault
Antoine
A
D000544:Alzheimer Disease / Q000175:diagnosis*; D017028:Caregivers / Q000523:psychology; D005194:Family Practice; D005602:France; D006801:Humans; D013315:Stress, Psychological / Q000523:psychology; D011795:Surveys and Questionnaires; D014342:Truth Disclosure