General practitioner referral of older patients to Improving Access to Psychological Therapies (IAPT): an exploratory qualitative study

Collins, N. and Corna, Laurie (2018) General practitioner referral of older patients to Improving Access to Psychological Therapies (IAPT): an exploratory qualitative study. BJPsych Bulletin, 42 (3). pp. 115-118.

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Abstract

Aims and method To understand general practitioner (GP) reticence to refer older patients to a local Improving Access to Psychological Therapies (IAPT) service providing mostly cognitive–behavioural therapy (CBT)-based interventions. Semi-structured, hour-long interviews were conducted with eight GPs and then analysed by modified grounded theory and thematic analysis. Results GP views regarding the treatability of older adults with CBT influenced their willingness to refer to a CBT-based IAPT service. Perceptions of local IAPT assessment processes being distressing and onerous to older patients also motivated referral inaction. GPs expressed a preference to treat depressed older patients themselves (with medication and psychological approaches such as watchful waiting). Clinical implications Any strategy to increase referral rates of older adults to CBT-based IAPT services should address local GP concerns regarding assessment processes and the effectiveness of offered treatments. Declaration of interest None.

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