Preventive Health Care Among Older Women in an Academic Primary Care Practice

Abstract

PURPOSE:To examine use of preventive health services among older women and to assess how age and illness burden influence care patterns. METHODS:The charts of 299 women aged 80+ and 229 women aged 65-79 who did not have dementia or terminal illness at one academic primary care practice in Boston were reviewed between July and December 2005 to determine receipt of screening tests (e.g., mammography), counseling on healthy lifestyle (e.g., exercise) and/or geriatric health issues (e.g., incontinence), and immunizations. Illness burden was quantified using the Charlson Comorbidity Index (CCI). RESULTS:Women aged 80+ were more likely than women aged 65-79 to have a CCI of 3+ (24.0% vs. 16.7%) and were less likely to receive all screening tests. However, receipt of mammography (47.8%) and colon cancer screening (51.2%) was still common among women aged 80+ and was not targeted to older women in good health. Women aged 80+ were less likely to be screened for depression (aRR 0.6 [0.5-0.8]), osteoporosis (aRR 0.6 [0.5-0.9]) or counseled about exercise (aRR 0.8 [0.6-0.9]) than younger women but were more likely to receive counseling about falls (aRR 1.9 [1.4-2.6]) and/or incontinence (aRR 1.8 (1.2-2.6). However notes documenting discussions about mood (28.6%), exercise (40.0%), falls (28.8%) or incontinence (20.8%) were low among all women. CONCLUSION:In a comprehensive review of preventive health measures for elderly women, many in poor health were screened for cancer. Meanwhile, many older women were not screened for depression or counseled about exercise, falls, or incontinence. There is need to improve delivery of preventive health care to older women.

Increased Osteoporosis Screening Rates Associated with the Provision of a Preventive Health Examination

“…18 It has been clearly demonstrated that the provision of preventive services for older Americans is suboptimal. 19,20 The face-to-face clinical encounter of the PHE seems to be a commonly used strategy. Crabtree et al 21 noted that the clinical encounter with the physician or allied health clinician was the primary locus for delivering preventive services.…”

Breast and Colorectal Cancer Screening and Associated Correlates among Chinese Older Women

“…Cervical screening, on the other hand, is not generally encouraged among women over 70, particularly those who have had normal tests during their reproductive years (Smith et al, 2010). A number of variables have been reported to affect the likelihood of taking of cancer preventive measures in older adults, including sociodemographic factors such 3 as age, race, marital status, education, financial status, insurance, and access to resources (Heflin et al, 2002;Kosiak et al, 2006;Bolen et al, 2007;Liu et al, 2008;Schonberg Leveille et al 2008;Schonberg York et al, 2008), and health-related factors such as self-rated health status, number of chronic illnesses, and mental and physical health (Messecar, 2000;Heflin et al, 2002;Resnick, 2003;Bolen et al, 2007;Schonberg Leveille et al 2008). However, none of these studies were conducted in the Western Pacific region, which has far more older people than any other area in the world (WHO, 2003).…”

Survey of Osteoporosis in an Inpatient Geriatric Psychiatric Setting: A Pilot Study

“…In another study at an academic primary care practice, Shonberg, York, Basu, Olveczky, and Marcantonio (2008), studied the charts of 299 women (aged ≥80) and 229 women (aged 65-79 years), who did not have dementia or terminal illness, to look at screening for cancer, osteoporosis, and geriatric issues (e.g., incontinence). Their study found that many elderly women were screened for cancer.…”