Clinician-patient communication during the diagnostic workup: The ABIDE project

Alzheimers Dement (Amst). 2019 Jul 29:11:520-528. doi: 10.1016/j.dadm.2019.06.001. eCollection 2019 Dec.

Abstract

Introduction: We aimed to describe clinician-patient communication in the diagnostic process of memory clinics, specifically clinician behavior known to facilitate knowledgeable participation of patients during consultations.

Methods: In this multicenter, observational study, we audio-recorded routine diagnostic consultations of 41 clinicians and 136 patients/caregivers at eight memory clinics. Patients/caregivers completed surveys after each audiotaped consultation. We used a study-specific coding scheme to categorize communication behavior.

Results: Clinicians often provided information on (results of) diagnostic testing. They infrequently invited questions and/or checked understanding. Clinician behavior to involve patients in decision-making about diagnostic testing was limited. Of note, patients/caregivers rarely expressed their information or involvement preferences. Yet, approximately, one quarter of them would have liked to receive more information.

Discussion: Involving patients more explicitly by means of shared decision-making could benefit the quality of care provided in memory clinics because it enables clinicians to attune the diagnostic workup to the individual patient's needs.

Keywords: Alzheimer's disease; Dementia; Diagnostic work-up; Doctor-patient communication; Patient engagement; Shared decision-making.