Comprehensive Geriatric Assessment CGA in general practice: Results from a pilot study in Vorarlberg, AustriaReport as inadecuate

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BMC Geriatrics

, 4:4

First Online: 19 May 2004Received: 13 February 2004Accepted: 19 May 2004


BackgroundMost comprehensive geriatric assessment CGA programs refer to hospital-based settings. However the body of geriatric healthcare is provided by general practitioners in their office. Structured geriatric problem detection by means of assessment instruments is crucial for efficient geriatric care giving in the community.

MethodsWe developed and pilot tested a German language geriatric assessment instrument adapted for general practice. Nine general practices in a rural region of Austria participated in this cross-sectional study and consecutively enrolled 115 persons aged over 75 years. The prevalence of specific geriatric problems was assessed, as well as the frequency of initiated procedures following positive and negative tests. Whether findings were new to the physician was studied exemplarily for the items visual and hearing impairment and depression. The acceptability was recorded by means of self-administered questionnaires.

ResultsOn average, each patient reported 6.4 of 14 possible geriatric problems and further consequences resulted in 43.7% 27.5% to 59.8% of each problem.

The items with either the highest prevalence and-or the highest number of initiated actions by the GPs were osteoporosis risk, urinary incontinence, decreased hearing acuity, missing pneumococcal vaccination and fall risk. Visual impairment was newly detected in only 18% whereas hearing impairment and depression was new to the physician in 74.1% and 76.5%, respectively.

A substantial number of interventions were initiated not only following positive tests 43.7% per item; 95% CI 27.5% to 59.8%, but also as a consequence of negative test results 11.3% per item; 95% CI 1.7% to 20.9%.

The mean time expenditure to accomplish the assessment was 31 minutes SD 10 min. Patients 89% and all physicians confirmed the CGA to provide new information in general on the patient-s health status. All physicians judged the CGA to be feasible in everyday practice.

ConclusionThis adapted CGA was feasible and well accepted in the general practice sample. High frequencies of geriatric problems were detected prompting high numbers of problem-solving initiatives. But a substantial number of actions of the physicians following negative tests point to the risks of too aggressive treatment of elderly patients with possibly subsequent negative effects.

Keywordsgeriatric assessment primary care prevalence screening  Download fulltext PDF

Author: Eva Mann - Michael Koller - Christian Mann - Tischa van der Cammen - Johann Steurer


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