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Age and Ageing, Vol 29, 353-356, Copyright © 2000 by British Geriatrics Society

ARTICLES

Short report. Compliance with recommendations in a geriatric outreach assessment service

R Esmail, K Brazil and M Lam
Program in Evidence-Based Care, Health Sciences Centre, McMaster University, Room 3H7, Hamilton, Ontario, Canada L8N 3Z5; Department of Clinical Epidemiology and Biostatistics, McMaster University Faculty of Health Sciences, Joseph's Community Health Centre, Hamilton, Ontario, Canada; Department of Community Health and Epidemiology, Queen's University, Kingston, Ontario, Canada; Corresponding author; e-mail: esmailr@fhs.mcmaster.ca

Objectives: to measure the extent to which the recommendations of a geriatric outreach assessment service were being followed, and to determine what patient-related factors were associated with compliance with assessment recommendations.Methods: eighty-one eligible patients or caregivers who had an assessment in a geriatric outreach service participated in a telephone interview. The interview focused on the use of health services and compliance with assessment recommendations. Patient-related variables obtained from charts included demographics, caregiver support and stability, health status and assessment recommendations.Results: overall compliance with recommendations from the geriatric outreach assessment services was 65%. Patients were less likely to comply fully with recommendations if they had a higher number of recommendations [odds ratio (OR) = 0.23; 95% confidence interval (CI) = 0.12-0.46; P = 0.0001], inadequate caregiver support (OR = 0.212; 95% CI = 0.04 to 1.02; P = 0.0523, or the ability to transfer themselves independently (OR = 0.12; 95% CI = 0.02-0.63; P = 0.0124). They were more likely to have full compliance if they had normal vision (OR = 6.67; 95% CI = 1.22-36.46; P = 0.0284).Conclusion: it is important to focus on key issues when developing service recommendations and on the role of the informal caregiver in facilitating compliance with them. Good communication between the patient or caregiver and the family physician and geriatric services can help to identify strategies which might improve acceptance of recommendations.Keywords: community-based service, compliance, geriatric assessment
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