Multidisciplinary team meetings (MDTM) in detection of Alzheimer's disease: data from the IDEM study.
BACKGROUND
The National Institute for Health and Clinical Excellence (NICE) in the United Kingdom, the Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen (IQWIG) in Germany and the Haute Autorité de Santé (HAS) in France have recently set out guidelines on prescription of anti-dementia medication. The HAS proposes in particular that continuation of these drugs for longer than one year should be decided in multidisciplinary team meetings (MDTM).


OBJECTIVE
To assess the feasibility of MDTM and the satisfaction of coordinating physicians from institutions for the dependent elderly (nursing home, NH) and expert physicians from memory clinics who have participated in the meetings.


METHODS
Survey carried out among physicians who had participated in the MDTM held as part of the IDEM study (Interest of systematic tracking of dementia cases in NH: analysing the contribution of MDTM in Alzheimer's disease and related diseases; PHRC National 2009, Code 0910701). The survey evaluated the organization of MDTM and the physicians' opinion of these meetings.


RESULTS
The cases of 574 patients were discussed in MDTM involving 133 healthcare professionals (32 coordinating physicians, 48 expert physicians, 4 general practitioners and 49 other health professionals). The mean number of participants was 4.2±1.6. About 16 minutes were spent discussing the case of each resident. About 90% of physicians considered that the meetings were useful. Overall assessment of their efficacy was 11.5/20 for the coordinating physicians and 14.1/20 for the expert physicians. The benefits of MDTM in relation to the work entailed were considered important by 60% of expert physicians and 33% of coordinating physicians.


CONCLUSIONS
Our survey confirmed the feasibility of MDTM in the field of Alzheimer's disease. The overall benefit/workload ratio of the meetings was considered to be favorable for the expert physicians. The benefits of MDTM were turned out to be less appreciated by the coordinating physicians according to high workload involved.
Gérontopôle de Toulouse, Département de Médecine Interne et Gérontologie Clinique, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France. rolland.y@chu-toulouse.fr
Y
Y
Rolland
N
N
Tavassoli
S
S
Gillette-Guyonnet
A
A
Perrin
S
S
Hermabessière
P-J
PJ
Ousset
F
F
Nourhashemi
P
P
Cestac
B
B
Vellas
D000544:Alzheimer Disease / Q000188:drug therapy*; D001291:Attitude of Health Personnel; D003226:Congresses as Topic; D004334:Drug Administration Schedule; D005602:France; D005858:Germany; D019538:Health Care Surveys; D006801:Humans; D033183:Interdisciplinary Communication; D008568:Memory; D009735:Nursing Homes; D010348:Patient Care Team; D010549:Personal Satisfaction; D010820:Physicians; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards*; D055656:Prescriptions / Q000592:standards*; D006113:United Kingdom; D016526:Workload