PCPs not addressing psychosocial issues in geriatric care

Study results show need for more discussion of most psychosocial topics among geriatric patients.
Study results show need for more discussion of most psychosocial topics among geriatric patients.

SAN ANTONIO—Primary care providers are not adequately discussing psychosocial topics such as alcohol use and sexual activity with older adult patients, according to research presented at the 2016 annual meeting of the American Academy of PAs (AAPA).

Older adult patients reported dissatisfaction with patient/provider discussions on a variety of topics, including alcohol use, sexual activity, mental health, home safety, and diet.

The study included 131 participants aged 65 years and older (mean age, 77.6 years) from 5 senior centers in the greater Buffalo, N.Y. region. Each participant completed a survey with 17 questions that included demographic information, quantitative measures of appointments, and topics regarding participant behavior and patient/provider discussions about certain psychosocial behavior. These behaviors included smoking, alcohol use, diet, physical activity, new-partner sexual activity, home safety (falls and harm), and exercise within the past year.

Smoking was reported by 6% of participants, alcohol use was reported by 58%, and new-partner sexual activity was reported by 8%. In addition, 78% reported eating a balanced diet, 54% reported being physically active, 18% reported a fall, 3% reported suffering harm, and 26% reported feeling depressed/anxious.

For patients who told their providers that they used alcohol, 50% were not asked about the behavior. For patients who told their providers that they had a new sexual partner in the past year, 91% were not asked about this behavior.

A significant number of patients who reported other issues were not asked about them: 39% of those who admitted to falls, 50% of those who reported emotional/physical harm, and 41% with mental health issues were not asked about these. Patients who denied eating a balanced diet were not asked about this behavior in 50% of cases, and patients who did not get enough physical activity were not asked about this in 34% of cases.

Patients who admitted to smoking were likely to be asked about this behavior by their providers, with 88% of those reporting the behavior being questioned.

Participants reported feeling that several topics were often not well addressed by providers. The following were rated as addressed “not well at all” by the majority of respondents: alcohol consumption (61%), diet (27%), sexual activity (62%), home safety (48%), and mental health (48%).

The presenters noted that their results show room for improvement in “an overwhelming majority” of psychosocial topics.

“Perhaps, if more emphasis were placed on consistently obtaining a complete social history, counseling sessions could proceed where appropriate and quality of life could be maximized in this vulnerable population,” they concluded.

Reference

  1. Chapman NM, Gilbert AR, Sawchuk CE, et al. Addressing the comprehensive geriatric assessment: social and psychological issues in the aging population. ePoster presented at: 2016 annual meeting of the American Academy of PAs (AAPA); May 14-18, 2016; San Antonio, TX.
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