Classification of severity of health problems in family/general practice: an international field trial

Parkerson, George R.; Bridges‐Webb, C; Gérvas, Juan; Hofmans-Okkes, Inge; Lamberts, H; Froom, Paul; Fischer, Gisela; Jong, Betty Meyboom-de; Bentsen, Bent Guttorm; Klinkman, Michael S.; Maeseneer, Jan De

doi:10.1093/fampra/13.3.303

Cited by 20 publications

(15 citation statements)

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confidence: 99%

“…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)(9)(10)(11)(12)(13)(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)(1)(2)(3)(4). Many of the identified health problems are typical of old age.…”

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confidence: 99%

“…Women reported 12 problems (IQ, 10-15), while men reported 9 problems (IQ, 7-11). In patients older than 80 years, the assessment uncovered 12 problems (IQ, 10-16) and in those aged 72 to 79 years 11 (IQ,(8)(9)(10)(11)(12)(13).A median of 2 health problems (IQ, 1-4) identified by STEP were new to the GP. In 107 of all 2185 (4.9%) health problems detected, information was missing on whether the problem was new to the GP; the results in this section are based on the remaining 95.1% of the problems.…”

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confidence: 99%

“…Results A median of 11 health problems (IQ,(8)(9)(10)(11)(12)(13)(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)(1)(2)(3)(4). Many of the identified health problems are typical of old age.…”

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Disclosure of New Health Problems and Intervention Planning Using a Geriatric Assessment in a Primary Care Setting

et al. 2010

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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)(9)(10)(11)(12)(13)(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)(1)(2)(3)(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. Improving the health of elderly patients in primary care is an important objective in the aging societies in most European countries. As the proportion of multimorbid and frail elderly people grows (1), health care providers are looking for new approaches to face this trend. Proactive and anticipatory approaches involving geriatric assessments have been introduced in some European countries. In Denmark, preventive home visits including geriatric assessment have been mandatory since 1996 (2), and the Single Assessment Process was introduced in the UK as part of the National Service Framework for elderly people in 2001 (3). In Germany, some general practitioners (GP) use components of geriatric assessments in a non-standardized way (4). Despite these efforts, health assessment of elderly people in primary care in Germany still remains a "black box" of measurements, procedures, and diagnostic as well as therapeutic interventions. Registration number: DRKS00000575Moreover, evidence for health effects of the geriatric assessm...

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Disclosure of New Health Problems and Intervention Planning Using a Geriatric Assessment in a Primary Care Setting

et al. 2010

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“…The Duke Severity of Illness (DUSOI) 60 The DUSOI is a measure of co-morbidity or the burden of illness during a specified week. It has been validated both as an instrument that can be used by a clinician at the time and for use immediately after a patient encounter by retrospective audit.…”

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confidence: 99%

Virtual outreach: a randomised controlled trial and economic evaluation of joint teleconferenced medical consultations

Wallace

Barber²,

Clayton³

et al. 2004

Health Technol Assess

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Duke Severity of Illness Checklist

Parkerson

2023

Encyclopedia of Quality of Life and Well-Being Research

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Classification of severity of health problems in family/general practice: an international field trial

Abstract: Although research is needed to improve reliability and to test validity further, the DUSOI was shown in the present study to be a methodology that is reasonable for consideration as an international classification of health problems by their severity in primary care patients.

Cited by 20 publications

References 8 publications

Disclosure of New Health Problems and Intervention Planning Using a Geriatric Assessment in a Primary Care Setting

Disclosure of New Health Problems and Intervention Planning Using a Geriatric Assessment in a Primary Care Setting

Virtual outreach: a randomised controlled trial and economic evaluation of joint teleconferenced medical consultations

Duke Severity of Illness Checklist

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