% 0期刊文章%诺曼·l·福斯特%南希·A·艾伦凯利·D·加勒特% %的安吉拉·王y %梅丽莎s Briley %凯文·m·达夫%剑应%姚他%里德霍尔布鲁克% T识别认知障碍是不够的:改善结果与认知专业团队保健(P6.216) % D J神经病学2017% % P P6.216 X % V % 88% N 16补充目的:比较以病人为中心的结果在小学和跨学科的认知专业团队的认知障碍。首页背景:推荐专业认知诊所在许多欧洲国家是公认的标准。在美国,认知专业诊所的作用是有争议的,推荐不一致,经常延误。设计/方法:我们召开一个顾问小组的患者和护理伙伴识别认知治疗结果他们发现重要。他们选择的结果1)提供家庭支持,2)避免不适当的药物,3)转诊驾驶评价和4)完成高级指令。我们回顾了电子病历临床护理访问期间生成确定这些结果。我们比较结果在8887例年龄> 65岁290年在初级保健社区诊所和病人评估在一个跨学科的认知专业诊所。二分结果的差异与卡方测试测试和计算结果与精确率比值判别法假设泊松分布。结果:社区诊所发现只有5.6%的老年患者认知障碍,从其他初级保健设置类似的报道,但远低于在流行病学研究中确定的11 - 26%。即使痴呆是公认的,患者在社区诊所是不太可能比患者认知专业团队实现以病人为中心的结果。家庭支持是4.2%比77%,不恰当的药物使用36%比9%、转诊驾驶评价0.8%比30% (p < 0.001)。 Only documented advanced directives were not significantly different, 24% vs. 27% (p = 0.43).Conclusions: Current strategies in primary care fail to identify as many patients with cognitive impairment as expected. Even when recognized, patient-centered outcomes are often not achieved. Specialty teams are more likely to attain patient-centered outcomes, but considerable opportunity for improvement remains. A prospective, randomized trial would address limitations of this retrospective, observational study.Study Supported by:Collaborative Research Support Program, University of UtahDisclosure: Dr. Foster has received personal compensation for activities with Piramal and Bristol-Myers Squibb as a consultant. Dr. Foster holds stock and/or stock options in Proactive Memory Services, Inc. Dr. Foster has received research support from GE Healthcare, the Center for Health Improvement, Northern California Institute of Research, and the Veterans Administration. Dr. Allen, Ph.D., ANP-BC has nothing to disclose. Dr. Garrett, Ph.D. has nothing to disclose. Dr. Wang, Ph.D. has nothing to disclose. Dr. Briley, PA-C, M.S. has nothing to disclose. Dr. Duff, Ph.D. has nothing to disclose. Dr. Ying, Ph.D. has nothing to disclose. Dr. He, M.S. has nothing to disclose. Dr. Holbrook, M.D., MPH has nothing to disclose. %U

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