International physicians identify obstacles to timely, accurate Alzheimer's diagnoses


The results of the International Alzheimer’s Disease Physician Survey are in and diagnostic practices amongst physicians are substantially out of touch, according to those queried.

A professional pool comprised of nearly 1,000 physicians hailing from five different countries was assessed by an Eli Lilly and Company survey regarding barrier beliefs known to arise in the Alzheimer’s diagnosing arena. Findings suggest that most of the world’s physicians struggle to detect the disease, let alone identify the condition within a preventative window.

Approximately half of the physician participants (45 percent) thought Alzheimer’s was “often” misdiagnosed. Moreover, 48 percent of survey contributors indicated that when the condition is successfully identified, it is “always” or “often” too late to intervene in a meaningful fashion.

“The survey has helped us to better understand why Alzheimer’s disease is a difficult diagnosis for physicians to make — and also confirmed that when diagnoses are made, physicians believe they are often made too late in the progression of the illness for physicians to intervene in a meaningful way,” Teresa A. Shewman, communications manager at Lilly Bio-Medicines, told PhysBizTech on behalf of her organization.

Among the most nettlesome obstacles mentioned by the surveyed cohort were the “lack of a definitive test, lack of communication [between patients and/or caregivers, physicians] and patient denial.”

"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, in a news release. "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 seemed to agree there are several benefits and care advantages that come with early detection of Alzheimer’s disease. Most cited the ability to incorporate specific treatments designed to slow the progression of cognitive impairment, buying more time for patients and their loved ones/caregivers to prepare for the later, exceedingly difficult stages of the disease. Eighty-five (85) percent of U.S. physicians were most adamant about providing their patients with such a service; 83 percent of U.K. doctors were similarly compelled.

Specifics of the survey were listed by Eli Lilly and Company as follows:

Barriers

Physician Response

Lack of definitive tests

  • 57 percent of physicians indicated they were "moderately satisfied" with tools available to make a formal Alzheimer's disease diagnosis. A lack of definitive tests was cited as the top barrier (65 percent) among physicians surveyed in all countries.

Lack of communication

  • 75 percent of physicians queried reported that discussions about Alzheimer's disease were initiated by patients and caregivers.
  • 44 percent of physicians surveyed reported that patients and/or caregivers initiated the discussion after they suspected "Alzheimer's disease was present for a while."
  • 40 percent 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.

Denial and stigma

  • 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 percent) and social stigma (59 percent).
  • 71 percent of respondents 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 U.K. and France reporting the most stigma (81 percent).
  • Physicians surveyed indicated that loss of personal freedom (78 percent), shame (63 percent) and possible isolation (60 percent) are mentioned by patients and/or caregivers as common stigmas.

“In response to the insights uncovered by this survey, Lilly plans to work with ADI [Alzheimer's Disease International] and other key stakeholders to develop educational resources to help aid in more effective patient and caregiver/physician conversations,” Shewman concluded.