Health problems at old age
Conditions
Interventions
Group 1: In both groups Study nurses perform the assessment and patients rate importance and severity of every health problem. Only in the intervention group patients and GPs get a list of the results
Sponsors
Institut für Allgemeinmedizin
Medizinische Hochschule Hannover
Eligibility
Sex/Gender
All
Age
72 Years to No maximum
Inclusion criteria
Inclusion criteria: - 72 years and over - capacity of visiting the GP´s practice - telephone access at home - signature of informed consent
Exclusion criteria
Exclusion criteria: - severely impaired hearing - current legal guardianship - pre-existing diagnosis of severe dementia - insufficient German language skills - participation in another clinical study
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The main objective of this study is to explore the effects of a Standardised Assessment for Elderly Patients in Primary Care (STEP) in combination with the directly following consultation with regard to measurable changes in patient’s perspective concerning his health problems and as compared to a control group. The patients´perspective is explored by ratings of importance and severity (emotional affection and functional hindrance) on a four point-likert skale at baseline and after the follow-up period of three months. In doing so we presume that most problems in older age are chronic conditions and will not vanish over time, but patients’ attitudes towards their problems may alter after discussing them with their GPs and possibly receiving further investigations and treatment. | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary aims are to - describe the nature, quantity and patterns of health problems in older general practice patients as identified by STEP and therewith to depict multimorbidity in general practice. - compare the patients´ perspective (patient’s ratings of importance) with the doctors´ perspective (doctors ratings of importance). - describe the interventions (diagnostic and therapeutic procedures) following the assessment: quantity and underlying type of health problem, which lead to the planning of an intervention and the accomplishment. - explore patient and doctor related factors that are associated with the initiation and accomplishment of interventions. The embedded qualitative study evaluates videotapes of 36 doctor-patient consultations following the STEP assessment whith regard to - Formal data (length of the consultation, length of discussion relating to every single health problem, order of the discussed health problems). - Are all problems uncovered by STEP discussed? Which problems are not addressed? Which ones are always approached? - How is the GP acting with regard to problems, which were unknown to him before? - Is there a different handling of problems, which have been rated as (very) important by the patient and/ or doctor in comparison to those rated less important? Does the verbal discussion reproduce the importance ratings as documented in the questionnaire? - Who is the player, who decides about further action and interventions, the patient or the doctor? - To what extend is a patient centred approach implemented? | — |
Countries
Germany
Contacts
Public ContactChristiane Müller
Institut für Allgemeinmedizin Medizinische Hochschule Hannover
Outcome results
None listed