What types of recommendations are we giving patients? A survey of clinical neuropsychologists.

OBJECTIVE: To identify types of recommendations that neuropsychologists most frequently give to patients, and determine which specific recommendations are most and least consistently given to patients across and within different diagnostic populations.

METHOD: A total of 309 clinical neuropsychologists completed a survey evaluating the frequency with which they made particular types of recommendations (e.g. driving, employment and education, health and rehabilitation referrals) to patients with various disorders (e.g. traumatic brain injury, dementia).

RESULTS: Recommendations in some categories were common across diagnoses (e.g. recommendations related to health). Neuropsychologists reported being more likely to give patients with dementia (relative to other clinical populations) recommendations related to educational resources, supervision and independence, and driving. Patients with a TBI diagnosis were more likely to be given recommendations related to employment and education, health and rehabilitation referrals, and mental health and substance use. Patients with a psychiatric diagnosis were more likely to be given recommendations related to mental health and substance use. Irrespective of diagnosis, neuropsychologists reported being most likely to give recommendations that could be implemented by the patient or caregiver without assistance from outside sources. Neuropsychologists varied in their use of recommendations to seek evaluations and treatment from health and rehabilitation referrals and in providing recommendations related to driving.

CONCLUSIONS: Recommendations provided within diagnostic groups are consistent with the etiology and prognosis of those conditions. Recommendations for the use of compensatory strategies to address cognitive deficits and recommendations to improve health were endorsed by the vast majority of neuropsychologists across diagnoses.