Joint consultations with general practitioners and geriatric psychiatrists for older adults with depression: a focus group study.

Abstract

Depression in older adults is common in general practice, but the optimal approach for identification and treatment is not entirely clear. To explore physicians' experiences with a structured collaborative model involving joint consultations between patients, general practitioners (GPs), and geriatric psychiatrists for managing depression in adults aged 65 years and older. Three focus group discussions were conducted with 13 physicians (10 GPs and 3 psychiatrists) who had participated in a structured collaboration model as part of a recent cluster randomized intervention study. Data were analyzed using Systematic Text Condensation. Five themes emerged: (1) diagnostic challenges; (2) perceived advantages; (3) feasibility; (4) concerns about overdiagnosis and overtreatment; and (5) suggested adjustments to the model. Somatic presentations often overshadowed depressive symptoms, particularly under GPs time constraints. Joint consultations strengthened the GP-patient relationship and enabled mutual learning. The presence of the GP was viewed as essential for patient engagement. The model addressed a treatment gap for GPs and was considered by psychiatrists to be highly cost-effective. All participants supported broader implementation in clinical practice. The GPs' enthusiasm for this collaborative approach indicates an unmet need in the treatment of older patients with depression. By strengthening both the doctor-patient relationship and interdisciplinary collaboration between GPs and psychiatrists in a cost-effective manner, the use of such joint consultations should be further investigated.