Dementia Treatment Can Be Improved by Seeing the Same GP
Monday, April 11th, 2022
People with dementia who see the same GP each time, have less health complications and fewer prescribed medications, according to a new study.
People with dementia often have comorbid or additional health problems. Consulting different doctors for individual health issues, rather than seeing the same GP continuously, can be associated with inappropriate prescribing. While continuity of care is generally accepted as best practice, there has been a lack of hard data in support.
British Cohort Study
A team of researchers from Exeter University, retrospectively analysed the records for 9,324 people aged 65 and over living with dementia in England, in 2016[1]. It included people who visited a GP at least three times in the previous year. Just under 9% of selected participants lived in an aged care facility. The participants had, on average, 14.5 consultations with a doctor over the twelve months.
The Importance of Continuity of Care
Participants were divided into quartiles, or four groups, ranging from highest continuity of GP care to lowest continuity of care. Those in the highest quartile were 35% less likely to develop delirium, 58% less likely to experience incontinence, and nearly 10% less likely to require emergency hospitalisation, as compared to participants in the lowest quartile. Participants with a high continuity of care were also less likely to face “extreme polypharmacy”, defined as ten or more prescriptions; or be given medication, such as benzodiazepines or diuretics, that can cause problems like incontinence, drowsiness and falls.
The observational nature of the study cannot indicate causation. Nor can we be sure of the mechanism. Nonetheless, the study implication is clear. Prioritising patients with dementia to have consistent access to their named GP can support better medication management and health outcomes for this often vulnerable community.
[1] https://bjgp.org/content/72/715/e91
