A patient-held minirecord to promote adult preventive care.
BACKGROUND
Compliance with guidelines for preventive service delivery to adults is inadequate. Patient-held minirecords have been successfully used to promote pediatric preventive care, and they hold promise for promoting adult preventive care as well. The objective of this project was to evaluate provider acceptance of a patient-held minirecord and the effect of this minirecord on compliance with a comprehensive set of adult preventive care guidelines.


METHODS
The patient-held minirecord was distributed to all patients in two practice groups of a residency-affiliated family medicine clinic over a 4-month period. Patients in a comparison group practice in the same clinic did not receive the minirecord. Provider acceptance was evaluated by a survey completed by the intervention group providers at the end of the 4-month period. The effect of the minirecord on compliance with preventive care guidelines was evaluated by a chart review that compared baseline compliance rates for individual patients and individual preventive services with compliance rates after 6 and 18 months.


RESULTS
Responses on the provider survey indicated a high rate of acceptance by intervention group providers of using the patient-held minirecord. It was believed to improve knowledge about and performance of preventive services without requiring significant additional effort or time commitment. The chart review found that provider compliance (defined as either ordering or performing a preventive service) was significantly improved for intervention group patients after 6 and 18 months. The intervention was beneficial for the delivery of a broad range of preventive services.


CONCLUSIONS
Use of a patient-held minirecord for adult preventive care can be well accepted by providers and lead to improvements in compliance with guidelines for adult preventive care.
Dickey
L L
LL
Department of Family and Community Medicine, University of California, San Francisco.
Petitti
D
D
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009740:Nursing Staff / Q000458:organization & administration; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D012495:San Francisco