Authors (including presenting author) :
Cheng SYR(1), Chan ML (1), Chan YH(1), Tse SY(1), Wong WM(2), Kwan YK(2), Lam SHC(3), Mak MY(4), Liang J(1), Au Yeung TW(5)
Affiliation :
(1)Department of Family Medicine and Primary Health Care, New Territories West Cluster; (2)Department of Medicine and Geriatrics, Tuen Mun Hospital; (3)Occupational Therapy Department, Tuen Mun Hospital; (4)Department of Physiotherapy, Tuen Mun Hospital; (5)Department of Medicine and Geriatrics, Pok Oi Hospital
Introduction :
CAEP was launched in 2016, providing services to elderly patients with memory complaints in primary care. This program involves a multidisciplinary team, including doctors from Family Medicine (FM) and Geriatrics, Occupational Therapist (OT) and Physiotherapist (PT).
Objectives :
(1) To provide early assessment and intervention for elderly patients with memory problem
(2) Empower the patients & caregivers with knowledge
(3) To provide appropriate and timely referral to Geriatric team for patients with dementia
(4) To improve function and quality of life of patients with memory impairment through structured program
Methodology :
Patients over 60 years old complained of memory decline were referred by GOPC doctors to this program. Assessment tests including HK-MoCA were performed by OT. With these assessment tests result and patient’s clinical condition, diagnosis was made by FM doctors. For patients diagnosed mild cognitive impairment (MCI), intervention and empowerment program would be offered by OT and PT. For patients diagnosed dementia, they would be referred to Geriatrician. Regular case conference would be arranged for discussion of those complicated cases, with input from Geriatrician sought for patient’s management. After 6 months, MCI patients would be reassessed by OT, and discharged if condition stable.
Result & Outcome :
967 patients had attended assessment by OT and FM doctors in 1/2016-12/2019. The average waiting time of this program in 2019 was 3.2 weeks. 366 (37.8%) patients were diagnosed MCI, 352 (36.4%) patients were diagnosed dementia, 170 (17.6%) patients were normal aging and 98 (10.1%) patients were diagnosed mood related disorder. Referral rate to Specialist Outpatient Clinic was 37.8% (366 patients required secondary care referral), which showed a significant reduction compared to 61.1% in 2014 before this program (p< 0.05). Conclusion CAEP can provide timely assessment and intervention for elderly patients with memory complaints, can reduce the referral rate and burden to secondary care, and also empower Family Physician in the management of these patients in public primary care setting.
