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Master Thesis

Le processus diagnostic et la prise en charge de la maladie d’Alzheimer en médecine générale dans le Finistère

Abstract : Ageing of French population expected in the years to come made Alzheimer's disease a public health issue. The purpose of this qualitative study is to describe the management of a patient suffering from Alzheimer's disease from the diagnosis to the follow-up care. Ten semi-directing interviews from general practitioner in South-Finistère were retained to reach data saturation. Data analysis was done according to the thematic method. Determining factors were found in the diagnosis process and follow-up care regarding Alzheimer’s disease. Imbalance of INR is one of the determinants leading to the diagnosis. It may be an interesting criterion since a large fraction of elderly patients are under vitamin K antagonist therapy, however, imbalance of treatment can be due to several causes. Can this criterion be adequate? The main difficulties encountered were denial on the patient and outsiders’ part. This denial could be linked to difficulties about accepting the disease, indeed negative projection persist amongst society. The general practitioner variously acknowledged delay in diagnosis. The lack of effective drugs seemed to be a drag on diagnosis though many general practitioners renewed them despite their lack of faith in such drugs. Non-drug treatments including paramedic assistances, accommodation, memory workshops… seemed to be a key element towards follow-up care of Alzheimer’s patients. These health measures improved thanks to Alzheimer’s plan 2008-2012 although training course of health-care providers should be continued; thus, some practitioners still found having an insufficient training in this area. This is the main improvement wished by the general practitioners interviewed. General practitioners’ roles were to suspect the disease, to have a proactive role and a role of guidance towards the patients. This guidance and supporting role was time-consuming and uneconomical due to a fee-for-service system. The new 2017’s medical convention sets up a new medical package on behalf of general practitioners for their elderly patients below and under eighty who are in ALD. Will this new compensation enhance the follow-up care of Alzheimer’s patients?
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01643085
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Submitted on : Tuesday, November 21, 2017 - 9:45:43 AM
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Coline Le Du. Le processus diagnostic et la prise en charge de la maladie d’Alzheimer en médecine générale dans le Finistère. Sciences du Vivant [q-bio]. 2017. ⟨dumas-01643085⟩

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