People with dementia less likely to develop delirium if they see same GP each time

People with dementia who get to see the same GP each time are given fewer medicines and are less likely to develop delirium and incontinence and have an emergency hospitalisation, according to a new study.

The research by Exeter University found people with dementia who were consistently seen by the same GP over the period of a year were given fewer medicines and were less likely to be given medication that can cause problems like incontinence, drowsiness and falls.

Those who saw the same GP were 35 per cent less likely to develop delirium, a state of confusion commonly experienced in dementia.

They were also 58 per cent less likely to have incontinence, and nearly ten per cent less likely to have an emergency hospitalisation, compared to those who saw a high number of different GPs in a year.

Lead author Dr João Delgado of the University of Exeter, said: "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."

Researchers analysed over 9,000 patient records of people diagnosed with dementia in the Clinical Practice Research Datalink.

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 policy makers 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 added: “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.”

The findings were also backed by Dementia UK director of Clinical Services, Paul Edwards, who said: “This research is consistent with calls to the Dementia UK Admiral Nurse Helpline, with families reporting lack of access to GP health appointments; this can be either when seeking a diagnosis or support around other health needs such as anxiety and depression, which are conditions closely linked to dementia.”

He added: “However GPs are undoubtedly facing undeniable pressure as they and other primary care services continue to be overstretched in the wake of Covid-19. GPs often have limited time to treat and diagnose dementia as well as attend to other health issues families may be facing. This means families with dementia miss out on the care and support they urgently need.”

He flagged up the charity’s dementia specialist Admiral Nurses who can work collaboratively with GPs to increase their awareness of dementia and improve patient and family health.

“This can all help to relieve time pressure on GPs and ensure that families get the support they need across every stage of dementia,” he said.

The paper ‘Continuity of general practitioner care for patients with dementia: Impact on prescribing and the health of patients’, was published in the British Journal of General Practice (BJGP).

To find out more delirium in people with dementia click here