Integrating geriatrics principles into primary care

2017 ◽  
pp. 217-222
Author(s):  
Alfonso J. Cruz-Jentoft
Keyword(s):  
Primary Care ◽  
Nursing Home ◽  
Chronic Disease ◽  
Older People ◽  
Primary Care Physicians ◽  
Older Patients ◽  
Nursing Home Care ◽  
Mental Function ◽  
Comprehensive Geriatric Care ◽  
Primary Care Management

Care of older people living in the community relies on primary care physicians. When the accumulation of ageing, chronic conditions, or acute problems has an impact on physical or mental function, comprehensive geriatric care has to be incorporated in usual primary care to understand, coordinate, manage, and prevent diseases and disabilities. Primary care physicians play key roles in the care of older subjects, including prevention and screening for diseases and geriatric problems, management of chronic disease and multimorbidity, detection and management of frailty and early disability, home, end-of-life and nursing home care, and continuity and customization of care. Incorporation of geriatric principles may improve performance and outcomes in each of these tasks. In addition, using some elements of comprehensive geriatric assessment in primary care management of older patients may help to improve outcomes.

scholarly journals Factors Associated With Primary Care Physicians’ Recognition of Cognitive Impairment in Their Older Patients

2014 ◽  
Vol 28 (4) ◽  
pp. 320-325 ◽  
Author(s):  
Mary C. Tierney ◽  
Gary Naglie ◽  
Ross Upshur ◽  
Liisa Jaakkimainen ◽  
Rahim Moineddin ◽  
...  
Keyword(s):  
Primary Care ◽  
Cognitive Impairment ◽  
Primary Care Physicians ◽  
Older Patients ◽  
Factors Associated

scholarly journals Cost of best‐practice primary care management of chronic disease in a remote Aboriginal community

2014 ◽  
Vol 200 (11) ◽  
pp. 663-666 ◽  
Author(s):  
Andrew P Gador‐Whyte ◽  
John Wakerman ◽  
David Campbell ◽  
Sue Lenthall ◽  
Janet Struber ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Care Management ◽  
Best Practice ◽  
Aboriginal Community ◽  
Primary Care Management

scholarly journals Non-Verbal Communication Between Primary Care Physicians and Older Patients: How Does Race Matter?

2011 ◽  
Vol 27 (5) ◽  
pp. 576-581 ◽  
Author(s):  
Irena Stepanikova ◽  
Qian Zhang ◽  
Darryl Wieland ◽  
G. Paul Eleazer ◽  
Thomas Stewart
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Older Patients ◽  
Verbal Communication

scholarly journals When Do Older Patients Change Primary Care Physicians?

2004 ◽  
Vol 17 (6) ◽  
pp. 453-460 ◽  
Author(s):  
J. W. Mold ◽  
G. E. Fryer ◽  
A. M. Roberts
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Older Patients

Primary care management of older people with mental health problems

2013 ◽  
Author(s):  
Louise Robinson ◽  
Carolyn Chew-Graham
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Older People ◽  
Care Management ◽  
Mental Health Problems ◽  
Age Groups ◽  
Real Life ◽  
Health Problems ◽  
Care Systems ◽  
Primary Care Management

This chapter discusses the presentation and primary care management of the commonest mental health problems in older people; these include delirium, delusions, depression and anxiety, and dementia. Primary care is on the front line in dealing with older people who have mental health problems, supporting their families to care for them and managing people with complex co-morbidities in addition to mental health issues. Older people consult their GP almost twice as often as other age groups and up to 40% may have a mental health problem. Cases drawn from the authors’ real-life practice are presented firstly to represent clinical presentations and management within primary care and secondly to demonstrate how primary care links with secondary care and the wider services. The management of patients is discussed largely within reference to UK primary care systems and policy, but the international readership should find parallels within their own healthcare systems.

scholarly journals Nutrition competence of primary care physicians in Saudi Arabia: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e033443 ◽  
Author(s):  
Osamah Al-gassimi ◽  
Hassan Bin Usman Shah ◽  
Rawan Sendi ◽  
Heba A Ezmeirlly ◽  
Lauren Ball ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Primary Care Physicians ◽  
Cross Sectional Study ◽  
Nutrition Knowledge ◽  
Sectional Study ◽  
Cross Sectional ◽  
Knowledge And Skills ◽  
Nutrition Care ◽  
Dietary Behaviours

ObjectivesPrimary care physicians have an opportunity to support healthy dietary behaviours of patients by providing nutrition care. However, it is unclear whether primary care physicians in the Kingdom of Saudi Arabia (KSA) are sufficiently competent in nutrition. This study aimed to assess the nutrition competence of primary care physicians in KSA and identify whether nutrition competence is associated with the provision of nutrition care to patients living with diet-related chronic disease.DesignA cross-sectional study.SettingChronic disease clinics across 48 primary care centres under the Ministry of Health in the city of Jeddah, KSA.Participants90 primary care physicians completed the survey (response rate: 98%). General practitioners and family medicine residents, specialists, and consultants actively working in chronic disease clinics between February and May 2019 were included.Primary and secondary outcome measuresPrimary outcome measure was nutrition competence of primary care physicians measured via the validated nutrition competence (NUTCOMP) questionnaire.ResultsPrimary care physicians perceived themselves as competent in nutrition care but their reported provision of nutrition care was limited. Confidence in their nutrition knowledge and skills elicited the lowest mean scores of 25.8 (±5.4) out of 35 and 29 (±5.2) out of 40, respectively. The reported provision of nutrition care was closely correlated with physicians’ confidence in their nutrition knowledge (r=0.57) and communication (r=0.52). Three factors were identified as predicting whether physicians provide nutrition care to patients: confidence in counselling about nutrition (p<0.001), having previous nutrition education (p=0.005) and a higher professional qualification (p=0.008).ConclusionsPrimary care physicians felt confident in providing nutrition care to patients living with diet-related chronic disease. Primary care physicians would benefit from higher levels of nutrition knowledge and skills to effectively support patients to improve their dietary behaviours and health conditions, leading to a positive impact on public health.

scholarly journals Implementation of data management and effect on chronic disease coding in a primary care organisation: A parallel cohort observational study

2016 ◽  
Vol 23 (3) ◽  
pp. 580 ◽  
Author(s):  
Michelle Greiver ◽  
Kimberly Wintemute ◽  
Babak Aliarzadeh ◽  
Ken Martin ◽  
Shahriar Khan ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Data Management ◽  
Chronic Conditions ◽  
Primary Care Physicians ◽  
Analytical Data ◽  
Data Repository ◽  
Chronic Obstructive ◽  
Care Organisation ◽  
Primary Care Organisation

Background Consistent and standardized coding for chronic conditions is associated with better care; however, coding may currently be limited in electronic medical records (EMRs) used in Canadian primary care.Objectives To implement data management activities in a community-based primary care organisation and to evaluate the effects on coding for chronic conditions.Methods Fifty-nine family physicians in Toronto, Ontario, belonging to a single primary care organisation, participated in the study. The organisation implemented a central analytical data repository containing their EMR data extracted, cleaned, standardized and returned by the Canadian Primary Care Sentinel Surveillance Network (CPCSSN), a large validated primary care EMR-based database. They used reporting software provided by CPCSSN to identify selected chronic conditions and standardized codes were then added back to the EMR. We studied four chronic conditions (diabetes, hypertension, chronic obstructive pulmonary disease and dementia). We compared changes in coding over six months for physicians in the organisation with changes for 315 primary care physicians participating in CPCSSN across Canada.Results Chronic disease coding within the organisation increased significantly more than in other primary care sites. The adjusted difference in the increase of coding was 7.7% (95% confidence interval 7.1%–8.2%, p < 0.01). The use of standard codes, consisting of the most common diagnostic codes for each condition in the CPCSSN database, increased by 8.9% more (95% CI 8.3%–9.5%, p < 0.01).Conclusions Data management activities were associated with an increase in standardized coding for chronic conditions. Exploring requirements to scale and spread this approach in Canadian primary care organisations may be worthwhile.

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