Compliance with disposition to primary care physicians and psychiatrists in elderly homebound mentally ill patients.
In a naturalistic study, the authors evaluated homebound mentally ill elderly patients as part of a psychiatric outreach team in two rural/semi-urban regions. Of the 80 patients evaluated in the two counties, 15 patients were admitted to nursing homes and were excluded from the analyses of follow-up data. Of the remaining 65 patients, 36 were referred to a primary care physician and 29 to a psychiatrist. The follow-up rate with primary care physicians (75%) was significantly greater than with psychiatrists (41% [P < 0.006]). At 3- to 6-month follow-up by telephone, patients who were compliant showed significantly greater clinical improvement than those who were not compliant (P < 0.0001). Overall, the higher follow-up rate for primary care physicians, compared with psychiatrists, reinforces the importance of educating and training primary care physicians in the diagnosis and management of mental disorders in elderly patients.
Habib
A
A
Columbia University-Binghamton Psychiatric Center, Geriatric Psychiatry Fellowship Program, New York State Office of Mental Health, NY 10032, USA.
Sanchez
M
M
Pervez
R
R
Devanand
D P
DP
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D010349:Patient Compliance; D011320:Primary Health Care; D011570:Psychiatry; D012017:Referral and Consultation