Evaluating care pathways in Alzheimer's disease: a qualitative interview study with GPs in England.

Abstract

To understand general practitioners' (GPs') experience of existing care pathways for people with moderate-severe Alzheimer's Disease (AD) and explore their attitudes towards potential modifications to these pathways. Secondary thematic analysis of qualitative interviews, originally conducted with GPs to explore prescribing of memantine in general practice. The theoretical domains framework was used to structure the data. The study participants were recruited via an online survey completed by GPs across England. Semi-structured, qualitative interviews were conducted with thirteen male and ten female GPs from a range of general practices in England. Insights into GPs' views and experiences regarding existing and possible care pathways for individuals with moderate to severe AD. Gaps in GPs' current levels of knowledge and skill in respect of caring for patients with moderate-to-severe AD affect their confidence and ability to identify opportunities for additional treatments. While GPs emphasise their role as providers of holistic care, features of the current healthcare context, including a lack of additional funding, inhibit their willingness to assume additional responsibilities as part of a revised pathway. A considerable knowledge, skills and confidence gap must be addressed to support the implementation of new care pathways that include revised responsibilities for GPs. GPs need appropriate support and resources to manage their patients' changing needs and to provide the best possible pharmacological management as the disease develops.