Hostname: page-component-8448b6f56d-xtgtn Total loading time: 0 Render date: 2024-04-16T14:12:36.241Z Has data issue: false hasContentIssue false
  • English
  • Français

Alzheimer's disease diagnosis disclosure in Brazil: a survey of specialized physicians' current practice and attitudes

Published online by Cambridge University Press:  06 September 2007

Irina Raicher ,
Marta Maria Shimizu ,
Daniel Yasumasa Takahashi ,
Ricardo Nitrini  and
Paulo Caramelli
Irina Raicher
Affiliation:
Behavioral and Cognitive Neurology Unit, University of São Paulo School of Medicine, São Paulo, Brazil
Marta Maria Shimizu
Affiliation:
Behavioral and Cognitive Neurology Unit, University of São Paulo School of Medicine, São Paulo, Brazil
Daniel Yasumasa Takahashi
Affiliation:
Behavioral and Cognitive Neurology Unit, University of São Paulo School of Medicine, São Paulo, Brazil
Ricardo Nitrini
Affiliation:
Behavioral and Cognitive Neurology Unit, University of São Paulo School of Medicine, São Paulo, Brazil
Paulo Caramelli*
Affiliation:
Behavioral and Cognitive Neurology Unit, University of São Paulo School of Medicine, São Paulo, Brazil
*
Correspondence should be addressed to: Professor Paulo Caramelli, Coordinator of the Behavioral and Cognitive Neurology Unit, Faculty of Medicine, Federal University of Minas Gerais, Av. Prof. Alfredo Balena, 190 – Room 4070, 30130-100, Belo Horizonte (MG), Brazil. Phone: +55 31 3248 9746; Fax: +55 31 3248 9745. Email: caramelp@usp.br.
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: There is little, though growing, interest in the research area of attitudes held among physicians towards disclosing the diagnosis of dementia and Alzheimer's disease (AD), or the current practice on AD disclosure. This study aimed to investigate the practice and attitudes of specialized physicians towards AD diagnosis disclosure in Brazil.

Methods: A questionnaire was devised to survey the current practice and attitudes regarding diagnosis disclosure of AD in Brazil and sent to specialized physicians (170 geriatricians, 300 neurologists and 500 psychiatrists) by electronic mail.

Results: From 970 potential respondents, 181 physicians who usually attend AD patients returned the questionnaire. There were no significant differences between the three specialties regarding the frequency with which they informed patients of their AD diagnosis (p = 0.17). The results revealed that only 44.8% of the physicians would regularly inform the patient of the diagnosis, although 85.6% of these use clear terminology. Despite their usual practice, 76.8% would want to know their diagnosis if they themselves were affected by AD.

Conclusions: Disclosure of AD diagnosis is not common among specialized physicians in Brazil and different factors are involved. In the clinical context, discussion on advantages of diagnosis disclosure can be useful for improving the care of AD patients and their families.

Keywords

dementiaAlzheimer diseasediagnosis disclosurebioethics
Type
Research Article
Information
International Psychogeriatrics , Volume 20 , Issue 3 , June 2008 , pp. 471 - 481
Copyright
Copyright © International Psychogeriatric Association 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Cantegreil-Kallen, I. et al. (2005). Disclosure of diagnosis of Alzheimer's disease in French general practice. American Journal of Alzheimer's Disease and Other Dementias, 20, 228–232.CrossRefGoogle ScholarPubMed
Clafferty, R. A., Brown, K. W. and McCabe, E. (1998). Under half of psychiatrists tell patients their diagnosis of Alzheimer's disease. BMJ, 317, 603.CrossRefGoogle ScholarPubMed
Erde, E. L., Nadal, E. C. and Scholl, T. O. (1988). On truth telling and the diagnosis of Alzheimer's disease. Journal of Family Practice, 26, 401–406.Google ScholarPubMed
Ferri, C. P. et al. (2005). Global prevalence of dementia: a Delphi consensus study. Lancet, 366, 2112–2117.CrossRefGoogle ScholarPubMed
Gilliard, J. and Gwilliam, C. (1996). Sharing the diagnosis: a survey of memory disorders clinics, their policies on informing people with dementia and their families, and the support they offer. International Journal of Geriatric Psychiatry, 11, 1001–1003.3.0.CO;2-I>CrossRefGoogle Scholar
Guttman, R. and Seleski, M. (1999). Diagnosis, Management and Treatment of Dementia. Chicago: American Medical Association.Google Scholar
Herrera, E. Jr., Caramelli, P., Silveira, A. S. and Nitrini, R. (2002). Epidemiologic survey of dementia in a community-dwelling Brazilian population. Alzheimer Disease and Associated Disorders, 16, 103–108.CrossRefGoogle Scholar
IBGE (2005). Instituto Brasileiro de Geografia e Estatistica: Tabúa Completa de Mortalidade. http://www.ibge.gov.br/home/estatistica/populacao/tabuadevida/2005/ambossexos.pdf.Google Scholar
Johnson, H., Bouman, W. P. and Pinner, G. (2000). On telling the truth in Alzheimer's disease: a pilot study of current practice and attitudes. International Psychogeriatrics, 12, 221–229.CrossRefGoogle ScholarPubMed
Meredith, C. et al. (1996). Information needs of cancer patients in West Scotland. BMJ, 313, 724–726.CrossRefGoogle ScholarPubMed
Novack, D. B. et al. (1979). Changes in physicians' attitudes toward telling the cancer patient. JAMA, 241, 897–900.CrossRefGoogle ScholarPubMed
Oken, D. (1961). What to tell cancer patients? JAMA, 175, 1120–1128.CrossRefGoogle ScholarPubMed
Polinsky, R. J. (1998). Clinical pharmacology of rivastigmine: a new-generation acetylcholinesterase inhibitor for the treatment of Alzheimer's disease. Clinical Therapeutics, 20, 634–647.CrossRefGoogle ScholarPubMed
Rice, K. and Warner, N. (1994). Breaking the bad news: what do psychiatrists tell patients with dementia about their illness? International Journal of Geriatric Psychiatry, 9, 467–471.CrossRefGoogle ScholarPubMed
Rice, K., Warner, N., Tye, T. and Bayer, A. (1997). Geriatricians' and psychiatrists' practice differs. BMJ, 314, 376.Google ScholarPubMed
Rogers, S. L. and Friedhoff, L. T. (1996). The efficacy and safety of donepezil in patients with Alzheimer's disease: results of a US multi-centre, randomised, double blind, placebo controlled trial. The Donepezil Study Group. Dementia, 7, 293–303.Google Scholar
Vassilas, C. A. and Donaldson, J. (1998). Telling the truth: what do general practitioners say to patients with dementia or terminal cancer? British Journal of General Practice, 48, 1081–1082.Google ScholarPubMed
Vilela, L. P. and Caramelli, P. (2006). Alzheimer's disease as viewed by relatives of patients at public and private clinics. Revista da Associação Médica Brasileira, 52, 148–152.CrossRefGoogle ScholarPubMed