Geriatric assessment in der hausarztpraxis - Eine studie der südtiroler akademie für allgemeinmedizin

Abstract

Background: Care for the old and elderly is an important task in general practice. We wanted to find out if general practitioners know the problems of their patients. Further on we wanted to know if patients and doctors agree in judging on the relevance of the problems a patient has. Methods: Participating doctors had to use an internationally used geriatric assessment instrument (STEP) in 30 randomly found patients. This was followed by a short clinical examination and a judgement by the doctor and the patient, separately, on the relevance of the problems a patient had. For all patients the duration and the quality of patient-doctor-relationship was identified as well as the location of the surgeries (rural or town). Results: 45 of around 200 eligible doctors with 894 of their patients took part. An average of 13 problems/patient - out of 40 possible - were found. 58% of the patients had at least one new problem identified. 17% of all problems were new problems, e.g. not known by the doctor yet. New problems are rarer when doctor and patient know each other for longer (e.g. 8 years and longer vs. less), the relationship is qualified as good (compared to "not so good") and the location of the surgery is in the countryside (vs. town). Corresponding judgements of doctors and patients concerning the relevance of a problem were found in 70% of all problems, but only in 51% of the new problems. Conclusion: A geriatric assessment is able to identify a relevant number of new problems - even when there is a long and good doctor-patient-relationship. There is a very relevant proportion of new problems doctors and their patients do not agree in their judgement of relevance of the problem. © Georg Thieme Verlag KG Stuttgart.