Abstract
In a changing dementia landscape, there is a need for innovative and sustainable solutions to keep dementia diagnosis and treatment accessible and scalable. The introduction of medication for Alzheimer’s disease underscores the necessity of precision medicine, as these drugs may be beneficial for some patients but certainly not for all. Even for those who are eligible, the medications carry a risk of side effects, further emphasizing the need for shared decision-making and effective communication. All these aspects can be supported by digital tools. However, despite the positive attitudes of end-users, many of these innovations remain unused. Therefore, this thesis aimed to improve the translation of digital tools into daily memory clinic practice by focusing on the end-users (physicians, patients, and care partners).
The key findings of this thesis indicate that end-users generally have positive attitudes towards digital tools (Chapters 2, 3, 6). Innovations such as digital cognitive testing and automated MRI quantification show promise for improving the diagnosis of dementia with Lewy bodies (DLB) (Chapters 4, 5) and maintaining accessibility and affordability of dementia diagnosis (Chapter 7). The assessment of the preferences and needs of the end-users led to the identification of several requirements to support the implementation of tools (Chapters 2, 3, 6, 8). These factors are centered around healthcare professionals, who need sufficient knowledge of the tool, time to learn it and become familiar with it, and the assurance of their clinical autonomy. The key considerations regarding the tool itself are ease of use, usefulness, relevance, and validity (Chapters 2, 6). Furthermore, professionals use the tool in a specific human environment, where important factors include the interaction between the patient and the professional, patient preferences, and the ability to tailor the tool accordingly (Chapters 3, 6, 8). Finally, the tool is used in a specific organizational environment, and its use depends on the clinical setting, where the workload is generally high. Therefore, the tool needs to be flexible and adaptable to fit seamlessly into work routines, and the provision of training, education, and real-time (administrative) support are important requirements to encourage its adoption (Chapters 6, 7, 8).
The future is at our doorstep and the use of digital tools in memory clinic practice could provide support for keeping dementia diagnosis and management accessible and scalable. The research in this thesis highlights the challenging reality of implementing digital tools in memory clinic practice by identifying and exploring the gap between the need for innovation and positive attitudes towards it, and its non-implementation in daily memory clinic practice. Finally, this thesis provides key recommendations to guide the road to successful implementation.
Original language | English |
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Qualification | PhD |
Awarding Institution |
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Supervisors/Advisors |
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Award date | 27 Sept 2024 |
Print ISBNs | 9789493353886 |
DOIs | |
Publication status | Published - 27 Sept 2024 |
Keywords
- Alzheimer’s disease
- diagnosis
- dementia
- digital tools
- implementation
- innovation
- Lewy body dementia
- MRI
- patient communication
- shared decision making