Clinicians’ communication with patients receiving a MCI diagnosis: The ABIDE project
Leonie N.C. Visser, Ingrid S. van Maurik, Femke H. Bouwman, Salka S. Staekenborg, Ralph Vreeswijk, Liesbeth Hempenius, Marlijn H. de Beer, Gerwin Roks, Leo Boelaarts, Mariska Kleijer, Wiesje M. van der Flier, Ellen M.A. Smets
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.