Stručni rad
Disclosure of New Health Problems and Intervention Planning Using a Geriatric Assessment in a Primary Care Setting
Christiane Annette Mueller
; Institute of General Practice Hannover Medical School Hannover, Germany
Renate Klaaßen-Mielke
; Department of Medical Informatics, Biometry and Epidemiology, Ruhr-University Bochum, Bochum, Germany
Erika Penner
; Institute of General Practice Hannover Medical School Hannover, Germany
Ulrike Junius-Walker
; Institute of General Practice Hannover Medical School Hannover, Germany
Eva Hummers-Pradier
; Institute of General Practice Hannover Medical School Hannover, Germany
Gudrun Theile
; Institute of General Practice Hannover Medical School Hannover, Germany
Sažetak
Aim To determine the prevalence of health problems uncovered
by a Standardized Assessment for Elderly Patients
in a Primary Care Setting (STEP), to explore how often STEP
uncovered conditions new to general practitioners (GP)
and ascertain how often STEP results led GPs to plan further
interventions.
Methods This descriptive, interim analysis was based on
the data of 189 elderly patients (median age, 78 years; interquartile
range [IQ], 74-81) and their 20 GPs collected in
Hannover region, Germany, between June 2008 and April
2009. Study nurses in the practice setting applied the 44-
item STEP instrument, based mainly on self-reporting, as
well as a standardized patient interview. Subsequently, GPs
indicated whether the problems were new to them, and
whether they planned further action or health interventions
on the basis of the problems identified by STEP.
Results A median of 11 health problems (IQ, 8-14) were
uncovered per patient, of which a median of 2 (IQ, 1-4)
were new to the GP and interventions were planned
for a median of 2 problems (IQ, 0-4). Many of the identified
health problems are typical of old age. The following
health problems uncovered by STEP were often new to the
GPs (percentages differ to numbers due to missing GP ratings):
cognitive impairment (33 of 64 affected by this problem,
73%), missing or unknown immunization status (84 of
160, 55%), and recent chest pain (19 of 37, 53%). Alcohol
misuse was new in all 4 affected patients (100%) and recent
falls were new in 5 of 7 patients (83%). Interventions
for affected patients were frequently planned for problems
of immunization (for 83 patients of 160 reporting the problem,
57%), current anxiety (4 of 9, 50%), and chest pain (14
of 37, 44%). Moreover, further management was frequently
planned for depression (10 of 29, 39%) and cognitive impairment
(16 of 64, 38%).
Conclusion Using a geriatric assessment in primary care
discloses relevant heath problems and treatment needs
that GPs may otherwise overlook.
Ključne riječi
aged; geriatric assessment; family practice; primary health care; prevalence; patients
Hrčak ID:
63525
URI
Datum izdavanja:
15.12.2010.
Posjeta: 1.248 *