The government is putting pressure on commissioners, who in turn are putting pressure on general practitioners, to make more diagnoses of dementia. Why has no analysis been done of the harm that such targets can cause, asks Martin Brunet, and where does it leave the doctor-patient relationship?
In their responses to Le Couteur and colleagues' article, Burns and colleagues state that fewer than half of people with dementia receive a formal diagnosis. 1 2 This commonly quoted claim is a misleading use of questionable prevalence data and needs to be challenged.The statistic they refer to is an estimate that currently 46% of those with dementia in the UK have received a diagnosis. 3 It is based on extrapolation of 20 year old data by a Delphi consensus group that met in 2007, 4 and more recent research suggests that the prevalence of dementia is much lower than thought, so diagnosis rates are higher than this estimate. 5 However, even if 46% is correct, it is misleading to state that fewer than half of people receive a diagnosis. Even if 54% of people with dementia in the UK are as yet undiagnosed, this does not mean that they will never receive a diagnosis, as Burns and colleagues imply. This misinterpretation of such an important statistic in the debate around the diagnosis of dementia is unhelpful and needs to be corrected.Competing interests: I have received income for writing and speaking from Pulse, and income for writing from Prescriber.
Relying on multidisciplinary team meetings to manage referrals to community mental healthcare is taking us further away from the goal of shared decision making, says Martin Brunet
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