Abstract：
Memory clinics (MCs) play a key role in accurate and timely diagnoses and treatment of dementia and mild cognitive impairment. However, within Australia, there are little data available on current practices in MCs, which hinder international comparisons for best practice, harmonisation efforts and national coordination. Here, we aimed to characterise current service profiles of Australian MCs.
The \'Australian Dementia Network Survey of Expert Opinion on Best Practice and the Current Clinical Landscape\' was conducted between August-September 2020 as part of a larger-scale Delphi process deployed to develop national MC guidelines. In this study, we report on the subset of questions pertaining to current practice including wait-times and post-diagnostic care.
Responses were received from 100 health professionals representing 60 separate clinics (45 public, 11 private, and 4 university/research clinics). The majority of participants were from clinics in metropolitan areas (79%) and in general were from high socioeconomic areas. While wait-times varied, only 28.3% of clinics were able to offer an appointment within 1-2 weeks for urgent referrals, with significantly more private clinics (58.3%) compared to public clinics (19.5%) being able to do so. Wait-times were less than 8 weeks for 34.5% of non-urgent referrals. Only 20.0 and 30.9% of clinics provided cognitive interventions or post-diagnostic support respectively, with 7.3% offering home-based reablement programs, and only 12.7% offering access to group-based education. Metropolitan clinics utilised neuropsychological assessments for a broader range of cases and were more likely to offer clinical trials and access to research opportunities.
In comparison to similar countries with comprehensive government-funded public healthcare systems (i.e., United Kingdom, Ireland and Canada), wait-times for Australian MCs are long, and post-diagnostic support or evidence-based strategies targeting cognition are not common practice. The timely and important results of this study highlight a need for Australian MCs to adopt a more holistic service of multidisciplinary assessment and post-diagnostic support, as well as the need for the number of Australian MCs to be increased to match the rising number of dementia cases.
The \'Australian Dementia Network Survey of Expert Opinion on Best Practice and the Current Clinical Landscape\' was conducted between August-September 2020 as part of a larger-scale Delphi process deployed to develop national MC guidelines. In this study, we report on the subset of questions pertaining to current practice including wait-times and post-diagnostic care.
Responses were received from 100 health professionals representing 60 separate clinics (45 public, 11 private, and 4 university/research clinics). The majority of participants were from clinics in metropolitan areas (79%) and in general were from high socioeconomic areas. While wait-times varied, only 28.3% of clinics were able to offer an appointment within 1-2 weeks for urgent referrals, with significantly more private clinics (58.3%) compared to public clinics (19.5%) being able to do so. Wait-times were less than 8 weeks for 34.5% of non-urgent referrals. Only 20.0 and 30.9% of clinics provided cognitive interventions or post-diagnostic support respectively, with 7.3% offering home-based reablement programs, and only 12.7% offering access to group-based education. Metropolitan clinics utilised neuropsychological assessments for a broader range of cases and were more likely to offer clinical trials and access to research opportunities.
In comparison to similar countries with comprehensive government-funded public healthcare systems (i.e., United Kingdom, Ireland and Canada), wait-times for Australian MCs are long, and post-diagnostic support or evidence-based strategies targeting cognition are not common practice. The timely and important results of this study highlight a need for Australian MCs to adopt a more holistic service of multidisciplinary assessment and post-diagnostic support, as well as the need for the number of Australian MCs to be increased to match the rising number of dementia cases.
摘要：
记忆诊所（MC）在准确，及时地诊断和治疗痴呆症和轻度认知障碍中起着关键作用。然而,在澳大利亚,关于MC当前实践的数据很少，这阻碍了最佳实践的国际比较，协调努力和国家协调。这里,我们的目的是描述澳大利亚MC的当前服务概况。
“关于最佳实践和当前临床景观的专家意见的澳大利亚痴呆症网络调查”于2020年8月至9月进行，作为部署用于制定国家MC指南的更大规模Delphi流程的一部分。在这项研究中,我们报告了与当前实践相关的问题子集,包括等待时间和诊断后护理.
来自代表60个独立诊所的100名卫生专业人员（45个公共诊所，11私人，和4个大学/研究诊所)。大多数参与者来自大都市地区的诊所（79％），通常来自高社会经济地区。虽然等待时间不同，只有28.3%的诊所能够在1-2周内预约紧急转诊，与公共诊所(19.5%)相比，私人诊所(58.3%)明显更多。对于34.5％的非紧急转诊，等待时间少于8周。只有20.0％和30.9％的诊所分别提供认知干预或诊断后支持，7.3%的人提供家庭康复计划，只有12.7%的人提供团体教育。大都会诊所利用神经心理学评估来处理更广泛的病例，并且更有可能提供临床试验和获得研究机会。
与拥有政府资助的全面公共医疗系统的类似国家相比(即，英国,爱尔兰和加拿大)，澳大利亚MC的等待时间很长，诊断后支持或以认知为目标的循证策略并不常见。这项研究的及时和重要的结果强调了澳大利亚MC需要采用更全面的多学科评估和诊断后支持服务，以及需要增加澳大利亚MC的数量以匹配痴呆症病例的增加。
“关于最佳实践和当前临床景观的专家意见的澳大利亚痴呆症网络调查”于2020年8月至9月进行，作为部署用于制定国家MC指南的更大规模Delphi流程的一部分。在这项研究中,我们报告了与当前实践相关的问题子集,包括等待时间和诊断后护理.
来自代表60个独立诊所的100名卫生专业人员（45个公共诊所，11私人，和4个大学/研究诊所)。大多数参与者来自大都市地区的诊所（79％），通常来自高社会经济地区。虽然等待时间不同，只有28.3%的诊所能够在1-2周内预约紧急转诊，与公共诊所(19.5%)相比，私人诊所(58.3%)明显更多。对于34.5％的非紧急转诊，等待时间少于8周。只有20.0％和30.9％的诊所分别提供认知干预或诊断后支持，7.3%的人提供家庭康复计划，只有12.7%的人提供团体教育。大都会诊所利用神经心理学评估来处理更广泛的病例，并且更有可能提供临床试验和获得研究机会。
与拥有政府资助的全面公共医疗系统的类似国家相比(即，英国,爱尔兰和加拿大)，澳大利亚MC的等待时间很长，诊断后支持或以认知为目标的循证策略并不常见。这项研究的及时和重要的结果强调了澳大利亚MC需要采用更全面的多学科评估和诊断后支持服务，以及需要增加澳大利亚MC的数量以匹配痴呆症病例的增加。
