Eli Lilly and Company announced results from the International Alzheimer's Disease Physician Survey of nearly 1,000 physicians that assessed physician attitudes and beliefs on the barriers to a formal Alzheimer's disease diagnosis. The survey, in recognition of World Alzheimer's Day (September 21, 2012), was conducted by Adelphi Research, on behalf of Lilly, in the United States (US), United Kingdom (UK), France, Italy and Japan.
Nearly half of all physicians surveyed (45 per cent) from the five participating countries responded that Alzheimer's disease is "often" misdiagnosed, with nearly half (48 per cent) indicating the diagnosis "always" or "often" occurs too late to intervene in a meaningful way. Lack of definitive tests, lack of communication between patients and/or caregivers and physicians, and patient denial, were cited as the most common barriers perceived by physicians as impacting their ability to make a formal Alzheimer's disease diagnosis, according to the survey results.
Eli Lilly and Company received results from the International Alzheimer's Disease Physician Survey which was conducted between July 11, 2012, and August 20, 2012, among physicians in the US, UK, France, Italy and Japan.
Additionally, physicians surveyed agreed that there are several advantages of an earlier diagnosis among Alzheimer's disease patients, including initiating treatment as soon as possible in an effort to slow progression of functional and cognitive impairment before they worsened, and allowing more time for patients and caregivers to adjust and prepare for the future. The latter was found to be most important to physicians who took part in the survey in the US (85 per cent) and UK (83 per cent). Physicians surveyed also acknowledged several disadvantages, including the news of an incurable disease to patients and family and the potential for isolation from other relatives and friends.
The majority of physicians indicated they were "moderately satisfied" (57 per cent) with tools available to make a formal Alzheimer's disease diagnosis. A lack of definitive tests was cited as the top barrier (65 per cent) among physicians surveyed in all countries.
Of the physicians surveyed, 75 per cent reported that discussions about Alzheimer's disease were initiated by patients and caregivers. Further, 44 per cent of physicians surveyed reported that patients and/or caregivers initiated the discussion after they suspected "Alzheimer's disease was present for a while." Additionally, 40 per cent of respondents reported that patients and caregivers did not provide enough information to help them make a formal diagnosis. When asked what information would aid them in making a more definitive diagnosis in the absence of clinical evidence, physicians surveyed indicated that reports about the types and durations of symptoms, how symptoms affect daily life, rate of decline and family history would help.
"The journey to receiving an Alzheimer's disease diagnosis can be a complex process," said Eric Siemers, MD, senior medical director of Lilly's Alzheimer's disease team. "Given a wide variety of emotions, it is often understandably difficult to communicate important information to physicians. We hope this survey is helpful to patients and caregivers as it highlights ways to partner more closely with their physicians."
Physicians who took part in the survey also reported that communicating an Alzheimer's disease diagnosis to patients can be difficult due to patient denial (65 per cent) and social stigma (59 per cent). The majority of respondents (71 per cent) agreed that there was at least a moderate level of stigma associated with Alzheimer's disease, with physicians who took part in the survey in the UK and France reporting the most stigma (81 per cent). Physicians surveyed also indicated that loss of personal freedom (78 per cent), shame (63 per cent) and possible isolation (60 per cent) are mentioned by patients and/or caregivers as common stigmas.
"Stigma remains a large area of concern for patients and their loved ones facing an Alzheimer's disease diagnosis, making acceptance of this debilitating disease that much more difficult," said Marc Wortmann, executive director, Alzheimer's Disease International. "We need to continue our efforts to educate the public about this illness to better accept the people living with Alzheimer's disease and other dementias."
To address these important needs, Lilly, Alzheimer's Disease International (ADI) and other key stakeholders plan to work together to develop educational resources to help aid in more effective patient/caregiver and physician conversations. These resources will focus on helping patients and caregivers better identify key cognitive symptoms that could indicate a more serious issue, as well as how best to communicate information and concerns to their physicians.
Alzheimer's disease, the most common form of dementia, causes progressive decline in memory and other aspects of cognition. Researchers do not know exactly what causes Alzheimer's disease and there are currently no approved treatments shown to alter the course of the underlying disease process, only treatment options that reduce certain symptoms of the disease.
A total of 996 physicians, consisting of primary care physicians (PCP), psychiatrists, neurologists, geriatricians and geriatric psychiatrists (UK only), participated. In order to qualify for the survey, physicians had to meet the following criteria: been in practice between two and 30 years; for PCPs and neurologists, greater than 70 per cent of their time must have been in direct patient care; for geriatricians, psychiatrists and geriatric psychiatrists (UK), greater than 50 per cent of their time must have been in direct patient care; all physicians must have seen at least 10 patients over the last three months, 50 percent of which must have been older than 19 years of age; all physicians had to indicate that they manage Alzheimer's disease on a regular basis; and all physicians must have agreed to Consent Agreement and Adverse Event reporting standards.
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