National survey of family physicians to define functional decline in elderly patients with minor trauma. Issue 1 (December 2016)

• Record Type: Journal Article
• Authors: Abdulaziz, Kasim; Brehaut, Jamie; Taljaard, Monica; Émond, Marcel; Sirois, Marie-Josée; Lee, Jacques; Wilding, Laura; Perry, Jeffrey
• Is Part Of: BMC family practice. Volume 17:Issue 1(2016)
• Page Start: 1
• Page End: 7
• Publication Date: 2016-12
• Subjects: Elderly -- Functional decline -- Activities of daily living (ADL) -- Emergency department -- Minor injuries; Family medicine -- Periodicals; Primary care (Medicine) -- Periodicals; 610.5
• DOI: 10.1186/s12875-016-0520-1
• Languages: English
• ISSNs: 1471-2296

Abstract

Abstract Background Failing to assess elderly patients for functional decline at the time around a minor injury may result in adverse health outcomes. This study was conducted to define what constitutes clinically significant functional decline and the sensitivity required for a clinical decision instrument to identify such functional decline after an injury in previously independent elderly patients. Methods After a thorough development process, a survey questionnaire was administered to a random sample of 178 family physicians. The surveys were distributed using a modified Dillman technique. Results From 143 eligible surveys, we received 67 completed surveys (response rate, 46.9 %). Respondents indicated that a drop of at least 3 points on the 28-point Older Americans Resources and Services (OARS) ADL Scale was considered clinically significant by 90 % of physicians. Ninety percent (90 %) of physicians would be satisfied with a sensitivity of 90 % or more for a clinical decision instrument to detect patients at risk of functional decline at 6 months following an injury. The majority of family physicians do not routinely assess the majority of the tasks on the OARS scale for injured elderly patients. Conclusions A high proportion of physicians (90 %) would consider a drop of 3 points on the OARS ADL Scale as significant to define functional decline and would be satisfied with a sensitivity of 90 % for a clinical decision instrument to detect such a decline. Any instrument to identify patients at elevated risk for subsequent decline should consider these outcome measures to be clinically useful.