"This first published study validates an innovative concept for providing comprehensive quality dementia diagnosis and care within primary care." -Dr. Michael Borrie, Director of the Aging Brain and Memory Clinic in London, Ontario
KITCHENER, Ontario, October 26, 2010 /Canada NewsWire/ - A made-in-Canada method of offering people with memory difficulties helpful care and supports without heavy dependence on scarce specialists is garnering interest from the medical community, including a nod from the November 2010 edition of the prestigious Journal of the American Geriatric Society, released today.
"Recognizing memory difficulties and seeking help as early as possible is a key step in living well with dementia," says David Harvey, Chief of Member Services at the Alzheimer Society of Ontario and one of the article's authors. "It is a hurdle that is hard to overcome for the person experiencing the problem, sometimes because help is hard to find. Yet unrecognized dementia can quickly spiral out of control, causing a host of other problems such as driving safety, financial difficulties and medication errors."
Memory clinic project in Kitchener, Ontario demonstrates high quality care and high level of patient and family satisfaction
The Journal's article profiles a unique interdisciplinary memory clinic project in the Centre for Family Medicine Family Health Team in Kitchener, Ontario. The project goal was to build capacity at a primary level of health care that would ensure quality assessment, diagnosis and management of dementia.
"Dementia is the chronic disease that is most difficult to diagnose and manage," says Dr. Michael Borrie, Director of the Aging Brain and Memory Clinic in London, Ontario. "It also has the most serious future cost implications for our health care system. This collaborative model of care between a Family Health Team (FHT)-based memory clinic, a lead family physician and supporting specialists is delivering timely patient-centred dementia care. It builds the necessary capacity for dementia diagnosis and management within FHTs as they become increasingly prevalent in Ontario. At the same time, this model utilizes limited specialist resources wisely and in a complementary manner. This first published study validates an innovative concept for providing comprehensive quality dementia diagnosis and care within primary care. I look forward to further evaluations as this model is more widely disseminated and integrated within the Ontario Health Care System."
Referrals to specialists reduced from 100% to 8%
Using a collaborative approach with family doctors, nurses, social workers, pharmacists, geriatricians and other specialists, the research project showed impressive results. Between July 2006 and September 2009, 151 high-risk patients were assessed in the clinic and almost 75% were diagnosed with some form of memory disorder. The clinic team was also able to offer treatment interventions and recommendations including social worker outreach, long-term care planning, coordination of home safety and driving assessments and community resource referrals, and periodic follow-up and monitoring. Referrals to specialists for more complex or unique cases were reduced from 100% to an appropriate 8%.
"Widespread adoption of this model of care has the potential to improve the quality of lives of these patients and their family members and offers a sustainable solution to the urgent need to increase our capacity for care for our aging Canadian population," comments Janet Kasperski, CEO of the Ontario College of Family Physicians. "The Ontario College of Family Physicians has worked with the Centre for Family Medicine Memory Clinic to develop an accredited inter-professional training program that has been used to establish primary care Memory Clinics in 12 other locations in Ontario."
The clinic was the brainchild of Dr. Linda Lee, a family physician in Kitchener, Ontario, Director of the Centre for Family Medicine Memory Clinic and assistant professor of Family Medicine at McMaster University. With an increasing number of people with signs of dementia, and an unacceptably long wait time to for specialist referrals, she recognized a need for change in the way these persons were cared for. The statistics were astonishing. An estimated two out of three people with dementia in the community were not being properly diagnosed and were therefore not receiving adequate care.
"The study is also a good example of what we call Knowledge Translation," says Dr. Micheline Gagnon, Head of Geriatric Services for McMaster University in Hamilton. "We have a growing body of research about the disease and disease management, but the stumbling block has been to get the diagnosis. This study shows that we can make use of the research by supporting family doctors to administer the tests and access appropriate treatments."
Dr. Gagnon also pointed out that patients who have been with their family doctors for years have a measure of comfort and confidence in being able to stay connected with that medical professional.
