Cargando…

A geriatric assessment in general practice: prevalence, location, impact and doctor-patient perceptions of pain

BACKGROUND: To investigate what a geriatric assessment in general practice adds towards previous findings of prevalence, location, impact and the dyadic doctor-patient perception of pain in this age group. METHODS: Cross-sectional study. Consecutive patients aged 70 and over underwent a comprehensiv...

Descripción completa

Detalles Bibliográficos
Autores principales: Kruschinski, Carsten, Wiese, Birgitt, Dierks, Marie-Luise, Hummers-Pradier, Eva, Schneider, Nils, Junius-Walker, Ulrike
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4730623/
https://www.ncbi.nlm.nih.gov/pubmed/26821717
http://dx.doi.org/10.1186/s12875-016-0409-z
_version_ 1782412432588668928
author Kruschinski, Carsten
Wiese, Birgitt
Dierks, Marie-Luise
Hummers-Pradier, Eva
Schneider, Nils
Junius-Walker, Ulrike
author_facet Kruschinski, Carsten
Wiese, Birgitt
Dierks, Marie-Luise
Hummers-Pradier, Eva
Schneider, Nils
Junius-Walker, Ulrike
author_sort Kruschinski, Carsten
collection PubMed
description BACKGROUND: To investigate what a geriatric assessment in general practice adds towards previous findings of prevalence, location, impact and the dyadic doctor-patient perception of pain in this age group. METHODS: Cross-sectional study. Consecutive patients aged 70 and over underwent a comprehensive geriatric assessment in general practice that included a basic pain assessment (severity, sites and impact). Patients with pain and their doctors then independently rated its importance. Pain was correlated with further findings from the assessment, such as overall health, physical impairments, everyday function, falls, mood, health related lifestyle, social circumstances, using bivariate and multivariate statistics. Patient-doctor agreement on the importance of pain was calculated using kappa statistics. RESULTS: 219 out of 297 patients (73.7 %) reported pain at any location. Pain was generally located at multiple sites. It was most often present at the knee (33.9 %), the lumbar spine (33.5 %) as well as the hip (13.8 %) and correlated with specific impairments such as restrictions of daily living (knee) or sleep problems (spine). Patients with pain and their physicians poorly agreed on the importance of the pain problem. CONCLUSIONS: A basic pain assessment can identify older patients with pain in general practice. It has resulted in a high prevalence exceeding that determined by encounters in consultations. It has been shown that a geriatric assessment provides an opportunity to address pain in a way that is adapted to older patients’ needs – addressing all sites, its specific impact on life, and the patients’ perceived importance of pain. Since there is little doctor-patient agreement, this seems a valuable strategy to optimize concrete treatment decisions and patient centered care. TRIAL REGISTRATION: This study is registered in the German Clinical Trial Register (DRKS00000792)
format Online
Article
Text
id pubmed-4730623
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-47306232016-01-29 A geriatric assessment in general practice: prevalence, location, impact and doctor-patient perceptions of pain Kruschinski, Carsten Wiese, Birgitt Dierks, Marie-Luise Hummers-Pradier, Eva Schneider, Nils Junius-Walker, Ulrike BMC Fam Pract Research Article BACKGROUND: To investigate what a geriatric assessment in general practice adds towards previous findings of prevalence, location, impact and the dyadic doctor-patient perception of pain in this age group. METHODS: Cross-sectional study. Consecutive patients aged 70 and over underwent a comprehensive geriatric assessment in general practice that included a basic pain assessment (severity, sites and impact). Patients with pain and their doctors then independently rated its importance. Pain was correlated with further findings from the assessment, such as overall health, physical impairments, everyday function, falls, mood, health related lifestyle, social circumstances, using bivariate and multivariate statistics. Patient-doctor agreement on the importance of pain was calculated using kappa statistics. RESULTS: 219 out of 297 patients (73.7 %) reported pain at any location. Pain was generally located at multiple sites. It was most often present at the knee (33.9 %), the lumbar spine (33.5 %) as well as the hip (13.8 %) and correlated with specific impairments such as restrictions of daily living (knee) or sleep problems (spine). Patients with pain and their physicians poorly agreed on the importance of the pain problem. CONCLUSIONS: A basic pain assessment can identify older patients with pain in general practice. It has resulted in a high prevalence exceeding that determined by encounters in consultations. It has been shown that a geriatric assessment provides an opportunity to address pain in a way that is adapted to older patients’ needs – addressing all sites, its specific impact on life, and the patients’ perceived importance of pain. Since there is little doctor-patient agreement, this seems a valuable strategy to optimize concrete treatment decisions and patient centered care. TRIAL REGISTRATION: This study is registered in the German Clinical Trial Register (DRKS00000792) BioMed Central 2016-01-28 /pmc/articles/PMC4730623/ /pubmed/26821717 http://dx.doi.org/10.1186/s12875-016-0409-z Text en © Kruschinski et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Kruschinski, Carsten
Wiese, Birgitt
Dierks, Marie-Luise
Hummers-Pradier, Eva
Schneider, Nils
Junius-Walker, Ulrike
A geriatric assessment in general practice: prevalence, location, impact and doctor-patient perceptions of pain
title A geriatric assessment in general practice: prevalence, location, impact and doctor-patient perceptions of pain
title_full A geriatric assessment in general practice: prevalence, location, impact and doctor-patient perceptions of pain
title_fullStr A geriatric assessment in general practice: prevalence, location, impact and doctor-patient perceptions of pain
title_full_unstemmed A geriatric assessment in general practice: prevalence, location, impact and doctor-patient perceptions of pain
title_short A geriatric assessment in general practice: prevalence, location, impact and doctor-patient perceptions of pain
title_sort geriatric assessment in general practice: prevalence, location, impact and doctor-patient perceptions of pain
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4730623/
https://www.ncbi.nlm.nih.gov/pubmed/26821717
http://dx.doi.org/10.1186/s12875-016-0409-z
work_keys_str_mv AT kruschinskicarsten ageriatricassessmentingeneralpracticeprevalencelocationimpactanddoctorpatientperceptionsofpain
AT wiesebirgitt ageriatricassessmentingeneralpracticeprevalencelocationimpactanddoctorpatientperceptionsofpain
AT dierksmarieluise ageriatricassessmentingeneralpracticeprevalencelocationimpactanddoctorpatientperceptionsofpain
AT hummerspradiereva ageriatricassessmentingeneralpracticeprevalencelocationimpactanddoctorpatientperceptionsofpain
AT schneidernils ageriatricassessmentingeneralpracticeprevalencelocationimpactanddoctorpatientperceptionsofpain
AT juniuswalkerulrike ageriatricassessmentingeneralpracticeprevalencelocationimpactanddoctorpatientperceptionsofpain
AT kruschinskicarsten geriatricassessmentingeneralpracticeprevalencelocationimpactanddoctorpatientperceptionsofpain
AT wiesebirgitt geriatricassessmentingeneralpracticeprevalencelocationimpactanddoctorpatientperceptionsofpain
AT dierksmarieluise geriatricassessmentingeneralpracticeprevalencelocationimpactanddoctorpatientperceptionsofpain
AT hummerspradiereva geriatricassessmentingeneralpracticeprevalencelocationimpactanddoctorpatientperceptionsofpain
AT schneidernils geriatricassessmentingeneralpracticeprevalencelocationimpactanddoctorpatientperceptionsofpain
AT juniuswalkerulrike geriatricassessmentingeneralpracticeprevalencelocationimpactanddoctorpatientperceptionsofpain