title: Community physicians' cooperation with a program of in-home comprehensive geriatric assessment.
abstract: OBJECTIVE
  To study the cooperation of primary care physicians with a community-based prevention and health promotion program for older persons, to study physician factors related to cooperation, and to determine any relationship between physician cooperation and patient adherence to program recommendations and patient satisfaction with health care.
  
  
  METHODS
  A survey administered in subjects' homes and physicians' offices in Santa Monica, California.
  
  
  METHODS
  Patients (n = 81) were intervention group subjects in a 3-year, randomized, controlled trial of in-home comprehensive geriatric assessment paired with prevention and health promotion. Physicians (n = 50) were selected if they had been contacted at least once by a study nurse practitioner about one of these patients.
  
  
  METHODS
  Physician cooperation was rated by study nurse practitioners. Physicians were interviewed to identify factors associated with cooperation. Patients' satisfaction with health care and adherence were measured prospectively throughout the 3-year program.
  
  
  RESULTS
  Physicians exhibiting better cooperation had fewer years in practice (P = .03) and were more likely to discuss the program with their patients (P = .005), see benefit for their patients from the program (P = .02), and rate program information as useful (P = .002). Higher physician cooperation did not predict higher patient satisfaction (P = .23) but did predict higher patient adherence to program recommendations (P = .02).
  
  
  CONCLUSIONS
  Physicians rated as cooperative were more likely to have a positive appraisal of the program, and their patients had higher adherence to program recommendations. These findings suggest that strategies for increasing primary care physician cooperation might improve effectiveness of similar community-based prevention and health promotion programs.
authors.affiliation: Multicampus Program in Geriatric Medicine and Gerontology, UCLA School of Medicine, USA.
authors.forename: C J
authors.initials: CJ
authors.lastname: Büla
authors.forename: C A
authors.initials: CA
authors.lastname: Alessi
authors.forename: H U
authors.initials: HU
authors.lastname: Aronow
authors.forename: K
authors.initials: K
authors.lastname: Yubas
authors.forename: M
authors.initials: M
authors.lastname: Gold
authors.forename: R
authors.initials: R
authors.lastname: Nisenbaum
authors.forename: J C
authors.initials: JC
authors.lastname: Beck
authors.forename: L Z
authors.initials: LZ
authors.lastname: Rubenstein
mesh_terms: D000368:Aged; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003153:Community Health Services; D005260:Female; D015577:Geriatric Assessment; D005851:Geriatric Nursing; D006266:Health Education; D006792:House Calls; D006801:Humans; D008297:Male; D009722:Nurse Practitioners; D017060:Patient Satisfaction; D010821:Physicians, Family / Q000523:psychology*; D011320:Primary Health Care