Physician implementation of and patient adherence to recommendations from comprehensive geriatric assessment.
The goals of this study were to develop and determine the feasibility of interventions designed to increase both primary care physician implementation of and patient adherence to recommendations from ambulatory-based consultative comprehensive geriatric assessment (CGA), and to identify sociodemographic and intervention-related predictors of physician and patient adherence.
PATIENTS AND METHODS
One hundred thirty-nine community-dwelling older persons who failed a screen for functional impairment, depressive symptoms, falls, or urinary incontinence received outpatient CGA consultation.
These patients and the 115 physicians who provided primary care for them received one of three adherence interventions, each of which had a physician education component and a patient education and empowerment component.
Recommendations were classified as physician-initiated or self-care and as « major » or « minor » ; one was deemed « most important. » Adherence rates were determined on the basis of face-to-face interviews with patients.
Based on 528 recommendations for 139 subjects, physician implementation of « most important » recommendations was 83% and of major recommendations was 78.5%. Patient adherence with physician-initiated « most important » and « major » recommendations were 81.8% and 78.8%, respectively.
In multivariate models, only the status of the recommendation of « most important » (odds ratio 2.4,95% CI [confidence interval] 1.3 to 4.5) and health...
Mots-clés Pascal : Médecin généraliste, Implémentation, Observance médicamenteuse, Ambulatoire, Relation médecin malade, Recommandation, Coût, Etats Unis, Vieillard, Amérique du Nord, Amérique, Homme
Mots-clés Pascal anglais : General practitioner, Implementation, Drug compliance, Ambulatory, Physician patient relation, Recommendation, Costs, United States, Elderly, North America, America, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0212674
Code Inist : 002B30A03B. Création : 199608.