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Higher continuity of GP care for patients with dementia was associated with safer prescribing and lower rates of major adverse events, according to new research.
The study published in the British Journal of General Practice found that increasing continuity of care for patients with dementia may also help improve treatment and outcomes.
This was a retrospective cohort study with 1 year of follow-up using anonymised medical records from 9,324 patients with dementia, aged 65 years living in England in 2016.
It found that the highest quartile of usual provider of care (highest continuity) had 34.8% less risk of delirium and 9.7% less risk of emergency admissions to hospital compared with the lowest quartile.
Polypharmacy and potentially inappropriate prescribing were identified in 81.6% (n = 7612) and 75.4% (n = 7027) of patients, respectively. The highest quartile had fewer prescribed medications and had fewer potentially inappropriate prescribings, including fewer loop diuretics in patients with incontinence, drugs that can cause constipation, and benzodiazepines with high fall risk.
GPs want to give patients with dementia the care they need and deserve
Professor Martin Marshall, Chair of the Royal College of GPs, said that continuity of care is highly valued by patients and GPs, and this research confirms these findings and shows it can be particularly beneficial for patients suffering from dementia.
He said: “Dementia can be a devastating condition for our patients, their families, and their carers – and the pandemic restrictions will have made things even more difficult, with disruption to people’s usual routines and increased isolation for many.
“GPs want to provide the best care they can to all their patients, including continuity for those who want and value it, but escalating GP workload and workforce shortages that pre-date the pandemic but have been exacerbated by the crisis, mean that it has become increasingly difficult to deliver.
“Ultimately, what is needed in order to allow GPs to deliver continuity of care to those patients who value it is more GPs and more members of the practice team so that we can spend more time with patients. The Government must urgently deliver on its manifesto pledge of 6,000 more GPs and thousands more members of the practice team so that GPs are able to give patients with dementia, and all their patients, the care they need and deserve.”