Clinicians' communication with patients receiving a MCI diagnosis: The ABIDE project

PLoS One. 2020 Jan 21;15(1):e0227282. doi: 10.1371/journal.pone.0227282. eCollection 2020.

Abstract

Background: We aimed to explore clinicians' communication, including the discussion of diagnosis, cause, prognosis and care planning, in routine post-diagnostic testing consultations with patients with Mild Cognitive Impairment (MCI).

Methods: Thematic content analysis was used to analyze audiotaped consultations in which 10 clinicians (eight neurologists and two geriatricians) from 7 memory clinics, disclosed diagnostic information to 13 MCI patients and their care partners. We assessed clinician-patient communication regarding diagnostic label, cause, prognosis and care planning to identify core findings.

Results: Core findings were: clinicians 1) differed in how they informed about the MCI label; 2) tentatively addressed cause of symptoms; 3) (implicitly) steered against further biomarker testing; 4) rarely informed about the patient's risk of developing dementia; 5) often informed about the expected course of symptoms emphasizing potential symptom stabilization and/or improvement, and; 6) did not engage in a conversation on long-term (care) planning.

Discussion: Clinicians' information provision about the underlying cause, prognosis and implications for long-term (care) planning in MCI could be more specific. Since most patients and care partners have a strong need to understand the patient's symptoms, and for information on the prognosis and implications for the future, clinicians' current approach may not match with those needs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Caregivers / education
  • Cognitive Dysfunction / diagnosis*
  • Cognitive Dysfunction / etiology
  • Cognitive Dysfunction / therapy
  • Communication*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Care Planning
  • Patient Education as Topic*
  • Physician-Patient Relations*
  • Prognosis
  • Qualitative Research
  • Referral and Consultation*
  • Surveys and Questionnaires

Grants and funding

This study is funded by ZonMW-Memorabel (ABIDE project; project lead WMvdF; project no 733050201), in the context of the Dutch 'Deltaplan Dementie', and the EU Joint Programme Neurodegenerative Disease Research (ADDITION project; to WMvdF and ISvM; grant no. 733051083). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.