The barriers and enablers of older person health assessments in Australian primary care: clinician and patient perspectives

Abstract

BackgroundHealth Assessments (HAs) were introduced for at-risk patients including older people, to have their health comprehensively monitored by their general practitioner (GP), to assess specific areas of health, such as risk factors for chronic disease and psychosocial problems, which may be overlooked in shorter consultations. Two forms of older person HAs are available for GPs to perform annually, HAs for non-Indigenous older Australians aged >75 (75+ HA) and for Aboriginal and Torres Strait Islander Australians aged >55 years (55+ ATSIHA).AimIn the present study, we aim to explore the perspectives of older Australians undertaking HA (both 75+HA and 55+ATSIHA) and clinician perspectives (GPs and practice nurses (PNs)) to enhance the items covered within the HA and develop targeted education resources to improve uptake of HAs.Study and DesignA qualitative study design incorporating semi-structured interviews and narrative inquiry was performed inviting patients (75+HA and 55+ATSIHAs) who have undergone HAs across two metropolitan general practice clinics. Clinicians who completed the HAs were also invited to participate in this study.MethodA total of 15 clinicians (11 GPs and 4 PNs) and 15 patients participated in this study. Thematic analysis was used to identify barriers and enablers of HAs.Results and ConclusionCommon barriers to both patients and clinicians include time, language, lack of relevance and fear of the unknown. Identification of risk factors and the opportunity to discuss topics not covered in shorter consults were common enablers for both patients and clinicians.