A UK study suggests that having appointments with the same GP can improve treatment for dementia, a development that may potentially influence how dementia consultations are conducted.
The research, which was led by the University of Exeter, analysed over 9,000 patient records of individuals diagnosed with dementia in the Clinical Practice Research Datalink, finding that for those people, appointments with the same GP improved treatment for dementia. The investigation showed that seeing the same GP lowered rates of health complications and fewer emergency hospital admissions.
The study, titled “Continuity of general practitioner care for patients with dementia: Impact on prescribing and the health of patients”, is published in the British Journal of General Practice (BJGP).
How was treatment for dementia improved?
The researchers carried out their investigation in anonymised patient records of individuals with dementia who, in 2016, were aged over 65 and included people who visited a GP at least three times in the previous year. They identified that people with dementia who were seen consistently by the same GP over a period of 12-months experienced improved treatment for dementia, receiving fewer medicines and were less likely to receive medicines that may lead to issues such as incontinence, drowsiness, and falls.
People who saw the same GP over time were 35% less likely to develop delirium – a state of confusion that is commonly experienced by people with dementia. Furthermore, those who consistently had the same GP were 58% less likely to experience incontinence, and 10% less likely to have an emergency hospitalisation compared to those who experienced the greatest variation in GPs treating them.
Dr João Delgado, the lead author of the research from the University of Exeter, commented: “The number of people with dementia has been rising steadily, and it is now one of the leading causes of death in the UK. In the absence of a cure, long-term care is particularly important. Treating people with dementia can be complex because it often occurs together with other common diseases. Our research shows that seeing the same general practitioner consistently over time is associated with improved safe prescribing and improved health outcomes. This could have important healthcare impacts, including reduced treatment costs and care needs.”
Enhancing future care
Delirium is a common symptom of dementia characterised as an episode of more severe confusion and raises an individual’s chances of death. Delirium and incontinence are extremely distressing for people with dementia and require additional NHS resources, in addition to hospital admissions that are a costly burden on the NHS.
Sir Denis Pereira Gray, co-author and GP researcher at the St Leonard’s Practice, said: “These new findings show that GP continuity is associated with important benefits for patients. Whilst national policymakers have for years discouraged continuity, general practices can still provide good GP continuity through their internal practice organisation, for example, by using personal lists.”
Dr Richard Oakley, Associate Director of Research at Alzheimer’s Society, said: “For the 900,000 people living with dementia in the UK, it’s likely dementia isn’t the only condition they’re getting treatment for.
“It’s clear from this study that consistently seeing the same GP has real benefits for people living with dementia – better management and treatment of conditions, and lower risk of complications like delirium and incontinence, leading to improved quality of life.
“The pandemic has put GP services under immense pressure, so while we might not be able to get consistent GP care for everyone with dementia tomorrow, policymakers should absolutely be working with the NHS to build this into their plans as we emerge from the pandemic.”
