We investigated whether the treatment needs of patients with dementia with Lewy bodies (DLB) and their caregivers, along with their attending physicians’ perception of those treatment needs, differ according to the clinical department visited by the patients. This was a subanalysis of a multicenter, cross-sectional, observational survey study. Data from the main study were classified according to the clinical department visited by the patient: psychiatric group (P-group), geriatric internal medicine group (G-group), and neurology group (N-group). The treatment needs of patients and caregivers were defined as “the symptom that causes them the most distress”, and the frequency of each answer was tabulated. This subanalysis included 134, 65, and 49 patient–caregiver pairs in the P-, G-, and N-groups, respectively. Statistically significant differences in patient background characteristics such as patient age; initial symptom domains; use of cholinesterase inhibitors, levodopa, antipsychotics, and Yokukansan; and total scores of the Mini-Mental State Examination, Neuropsychiatric Inventory-12, and Movement Disorder Society-Unified Parkinson’s Disease Rating Scale Parts II and III were shown among the three subgroups. While there were no differences in patients’ treatment needs among the subgroups, residual analysis showed that in the N-group, parkinsonism was more of a problem than other symptom domains (p = 0.001). There were significant differences in caregivers’ treatment needs among the three subgroups (p < 0.001). The patient–physician concordance rates for the symptom domains that caused patients the most distress were: P-group, 42.9% (kappa coefficient [κ] = 0.264); G-group, 33.3% (κ = 0.135), and N-group, 67.6% (κ = 0.484). The caregiver–physician concordance rates for the symptom domains that caused the caregivers the most distress were: P-group, 54.8% (κ = 0.351), G-group, 50.0% (κ = 0.244), and N-group, 47.4% (κ = 0.170). This subanalysis revealed differences in the treatment needs of patients with DLB and their caregivers according to the clinical department they attended. There might be a lack of awareness of those treatment needs by the attending physicians, regardless of their specialty. UMIN Clinical Trials Registry UMIN000041844.

中文翻译：

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根据患者就诊的临床科室，路易体痴呆患者及其照顾者的治疗需求差异以及医生对这些治疗需求的认识差异：观察性调查研究的子分析

我们调查了路易体痴呆 (DLB) 患者及其护理人员的治疗需求以及他们的主治医生对这些治疗需求的看法是否因患者就诊的临床科室而异。这是一项多中心、横断面、观察性调查研究的子分析。主要研究的数据根据​​患者就诊的临床科室进行分类：精神科组（P组）、老年内科组（G组）和神经科组（N组）。患者和护理人员的治疗需求被定义为“导致他们最痛苦的症状”，并将每个答案的频率制成表格。该子分析分别包括 P 组、G 组和 N 组中的 134、65 和 49 对患者-护理人员。患者背景特征（例如患者年龄）存在统计学上的显着差异；初始症状范围；使用胆碱酯酶抑制剂、左旋多巴、抗精神病药和抑肝散；三个亚组的简易精神状态检查、神经精神量表12、运动障碍协会-统一帕金森病评定量表第二部分和第三部分的总分也显示出来。虽然亚组之间患者的治疗需求没有差异，但残差分析显示，在 N 组中，帕金森症比其他症状领域更成问题 (p = 0.001)。三个亚组中看护者的治疗需求存在显着差异 (p < 0.001)。对于导致患者最痛苦的症状领域，患者与医生的一致性率为： P 组，42.9%（kappa 系数 [κ] = 0.264）；G 组，33.3% (κ = 0.135)，N 组，67.6% (κ = 0.484)。对于导致护理人员最痛苦的症状领域，护理人员与医生的一致性率为：P 组，54.8% (κ = 0.351)，G 组，50.0% (κ = 0.244)，N 组，47.4% （κ = 0.170）。该子分析揭示了 DLB 患者及其护理人员根据就诊的临床科室的不同，其治疗需求存在差异。主治医生可能缺乏对这些治疗需求的认识，无论他们的专业如何。UMIN 临床试验注册中心 UMIN000041844。