Chronic pruritus (CP) has become a significant health problem affecting the elderly in community settings. Community health service institutions plays a crucial role in chronic disease management, but the current state of medical services for elderly patients with CP is still unclear.

This study aims to explore the current status and challenges of CP services for the elderly in community settings, and to propose actionable recommendations for enhancing the comprehensive service capabilities of general practitioners.

Between April and May 2024, semi-structured in-depth interviews were conducted with general practitioners working in Beijing community health service institutions using purposive sampling. The interview guidelines were composed of several open questions, including outpatient consultations, current service provision, challenges encountered and suggestions for service improvement. Thematic framework analysis was used to analyze the data, and findings were reported according to the Consolidated Criteria for Reporting Qualitative Research (COREQ) .

A total of 15 general practitioners were interviewed. The interview themes included 4 main themes and 19 sub-themes, which were: (1) Current status of outpatient consultations: prevalent among elderly patients, diverse etiologies and significant impacts on health; (2) Service provision: drug therapy, health education, follow-up visits and drug dispensing; (3) Existing challenges: insufficient professional knowledge, lack of high-quality training, inadequate attention to CP, low patient awareness, underutilization of clinical guidelines, limited medical resources and insufficient service promotion; (4) Improvement suggestions: establishing a standardized pruritus management process, implementing needs-based training, integrating pruritus care into existing chronic disease management programs, fostering a supportive environment, developing traditional Chinese medicine services and promoting sub-specialties development.

There is an imbalance between the supply and demand for CP services for the elderly in community health settings. To address this, the feasible methods include strengthening physician training, establishing standardized diagnostic and treatment protocols, integrating pruritus management into chronic disease management programs, and developing high-quality clinical practice guidelines in primary care.