Would doctors routinely asking older patients about their memory improve dementia outcomes? No

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f1745 (Published 26 March 2013)
Cite this as: BMJ 2013;346:f1745

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  1. Margaret McCartney, general practitioner
  1. 1Glasgow, UK
  1. margaret{at}margaretmccartney.com

The UK government is planning to introduce incentives for general practitioners to check for dementia in all patients aged 75 and older. Jill Rasmussen (doi:10.1136/bmj.f1780) says that it will allow earlier support for patients with dementia, but Margaret McCartney says that industry has more to gain than patients

We are already screening for dementia. Never mind the evidence based conclusion from the UK National Screening Committee that “screening should not be offered,”1 our hospitals now receive financial incentives to do exactly that.

In early 2012 the Department of Health’s new Commissioning for Quality and Innovation (CQUIN) payments aimed to increase the rate of diagnosis of Alzheimer’s disease by asking everybody admitted to hospital over the age of 75 whether they have been more forgetful in the past 12 months to the extent that it has significantly affected their daily life.2 The question has to be asked within 72 hours of admission, and hospitals must achieve 90% compliance over three consecutive months before payment. Patients answering “yes” must have a “diagnostic assessment.”

The CQUIN document says that this is “awareness raising rather than formal screening.” But what is screening if it is not looking for a condition that the patient did not complain of …

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