Adherence to recommendations of community-based comprehensive geriatric assessment programmes.
BACKGROUND
non-adherence to the recommendations of short-term community-based consultative comprehensive geriatric assessment programmes is a threat to the effectiveness of these programmes.


OBJECTIVE
to synthesize the literature on patient and physician adherence to recommendations of community-based comprehensive geriatric assessment programmes.


METHODS
I identified papers cited by an English language literature search of MEDLINE, Health Star and CINAHL databases from January 1980 to November 1999. This search was supplemented with literature identified from the reference sections of these publications.


RESULTS
patient adherence rates ranged from 46 to 76%, which approximates to the rates for the consulting physician adherence (49-79%). I identified many characteristics of patient, treatment, care provider and clinical setting which influenced adherence. Understanding these factors has led to the development of adherence-enhancing strategies. However, without systematic evaluations it is difficult to evaluate the relative effectiveness of these interventions.


CONCLUSIONS
further research which targets more representative samples and uses validated assessment tools and multiple data collection methods is needed to expand our knowledge of patterns and predictors of adherence and to evaluate the relative effectiveness of adherence-enhancing intervention strategies.
Aminzadeh
F
F
Regional Geriatric Assessment Program of Ottawa-Carleton, Queensway Carleton Hospital, Ontario, Canada. faminzadeh@qch.ochin.on.ca
D000368:Aged; D003153:Community Health Services / Q000592:standards*; D005194:Family Practice / Q000592:standards*; D015577:Geriatric Assessment; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006302:Health Services Research; D006801:Humans; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010819:Physician's Role; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D015397:Program Evaluation; D011785:Quality Assurance, Health Care / Q000458:organization & administration