National survey of family physicians to define functional decline in elderly patients with minor trauma

BMC Family Practice

Research Article

Jeffrey J. Perry¹  Laura Wilding²  Jacques S. Lee³  Kasim E. Abdulaziz⁴  Jamie Brehaut⁴  Monica Taljaard⁴  Marcel Émond⁵  Marie-Josée Sirois⁶ 

[1] Clinical Epidemiology Program, University of Ottawa, Ottawa, ON, Canada;Department of Epidemiology and Community Medicine, Ottawa Hospital Research Institute, Ottawa, ON, Canada;Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada;Epidemiology Program, F6, The Ottawa Hospital, Civic Campus 1053 Carling Avenue, K1Y 4E9, Ottawa, ON, Canada;Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada;Department of Emergency Medicine, University of Toronto, Clinical Epidemiology Unit, Sunnybrook Health Sciences Center, Toronto, ON, Canada;Department of Epidemiology and Community Medicine, Ottawa Hospital Research Institute, Ottawa, ON, Canada;Clinical Epidemiology Program, University of Ottawa, Ottawa, ON, Canada;Department of Family and Emergency Medicine, Université Laval, Laval, QC, Canada;Unité de recherche en traumatologie-urgence-soins intensifs du Centre de recherche FRQ-S du CHA de Québec, Laval, QC, Canada;Département de réadaptation, Université Laval, Laval, QC, Canada;Unité de recherche en traumatologie-urgence-soins intensifs du Centre de recherche FRQ-S du CHA de Québec, Laval, QC, Canada;

关键词: Elderly;    Functional decline;    Activities of daily living (ADL);    Emergency department;    Minor injuries;   

DOI  :  10.1186/s12875-016-0520-1

 received in 2015-08-22, accepted in 2016-08-16,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundFailing to assess elderly patients for functional decline at the time around a minor injury may result in adverse health outcomes. This study was conducted to define what constitutes clinically significant functional decline and the sensitivity required for a clinical decision instrument to identify such functional decline after an injury in previously independent elderly patients.MethodsAfter a thorough development process, a survey questionnaire was administered to a random sample of 178 family physicians. The surveys were distributed using a modified Dillman technique.ResultsFrom 143 eligible surveys, we received 67 completed surveys (response rate, 46.9 %). Respondents indicated that a drop of at least 3 points on the 28-point Older Americans Resources and Services (OARS) ADL Scale was considered clinically significant by 90 % of physicians. Ninety percent (90 %) of physicians would be satisfied with a sensitivity of 90 % or more for a clinical decision instrument to detect patients at risk of functional decline at 6 months following an injury. The majority of family physicians do not routinely assess the majority of the tasks on the OARS scale for injured elderly patients.ConclusionsA high proportion of physicians (90 %) would consider a drop of 3 points on the OARS ADL Scale as significant to define functional decline and would be satisfied with a sensitivity of 90 % for a clinical decision instrument to detect such a decline. Any instrument to identify patients at elevated risk for subsequent decline should consider these outcome measures to be clinically useful.

【 授权许可】

CC BY   
© The Author(s). 2016