'Take care of it, general practitioner' - a qualitative study about barriers and needs in general practice caring for people newly diagnosed with dementia.

backgroundDespite frequent visits to general practice, older people often experience delays in receiving a diagnosis of dementia. In some cases, the diagnosis is made during an acute hospital stay. In this case the transition from inpatient to outpatient care poses significant challenges, particularly due to poor communication between healthcare services. General practitioners (GPs), who play a central role in managing post-diagnostic care, therefore face difficulties in ensuring continuity of care. In order to effectively support their patients, GPs require comprehensive information from all healthcare professionals involved in the care process. This study examines how GPs manage the care of patients newly diagnosed with dementia during a hospital stay, and identifies strategies to improve support for their patients.

methods16 semi-structured interviews were conducted with GPs from Germany. The interviews were transcribed and analysed using qualitative content analysis according to Kuckartz. The categories were developed both deductively and inductively from the data material in an interprofessional team.

resultsThe interviews highlighted that the discharge management for people newly diagnosed with dementia often fails to ensure a seamless transition to outpatient care. To overcome resulting barriers, GPs prioritise the coordination of patients’ further care in their own homes during the first consultation after discharge. The most important tasks further include reviewing the diagnosis, considering differential diagnoses such as delirium or depression and updating the medication plans. GPs identified two main approaches to improving the care for patients newly diagnosed with dementia: (1) standardised discharge management and (2) the inclusion of additional professional groups such as care managers or social workers.

conclusionBy focusing on GPs’ perspectives, our study provides novel insights into the challenges of post-discharge care for patients with newly diagnosed dementia in Germany, highlighting specific barriers and opportunities to improve cross-sectoral collaboration and patient support. It has been shown that persistent structural barriers hinder the provision of adequate care in general practice. Overcoming these challenges by strengthening communication and information flow across healthcare sectors, e.g. through consistent discharge management, interdisciplinary collaboration or the implementation of functional digital communication platforms, could improve care for this patient group in a sustainable way.

trial registrationThe results presented in this article are part of the MeDeKa study, which was funded by the German Alzheimer’s Society. A study protocol was registered at the German Registry for Clinical Trials on 30 June 2021 (DRKS-ID: DRKS00025061).