Assessment of dizziness among older patients at a family practice clinic: a chart audit study.
BACKGROUND
Dizziness is a common complaint among the elderly with a prevalence of over 30% in people over the age of 65. Although it is a common problem the assessment and management of dizziness in the elderly is challenging for family physicians. There is little published research which assesses the quality of dizziness assessment and management by family physicians.


METHODS
We conducted a retrospective, chart audit study of patients with dizziness attending the Sunnybrook Family Practice Center of Sunnybrook and Women's College Health Sciences Center (SWCHSC) in Toronto. We audited a random sample of 50 charts of patients from 310 eligible charts. Quality indicators across all dizziness subtypes were assessed. These quality indicators included: onset and course of symptoms; symptoms in patients' own words; number of medications used; postural blood pressure changes; symptoms of depression or anxiety; falls; syncope; diagnosis; outcome; specialty referrals. Quality indicators specific to each dizziness subtype were also audited.


RESULTS
310 charts satisfied inclusion criteria with 20 charts excluded and 50 charts were randomly generated. Documentation of key quality indicators in the management of dizziness was sub-optimal. Charts documenting patients' dizziness symptoms in their own words were more likely to have a clinical diagnosis compared to charts without (P = 0.002).


CONCLUSIONS
Documentation of selected key quality indicators could be improved, especially that of patients' symptoms in their own words.
Kwong
Eugene C K
EC
Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada. eckkwong@hotmail.com
Pimlott
Nicholas J G
NJ
D000368:Aged; D004244:Dizziness / Q000175:diagnosis* / Q000628:therapy; D005194:Family Practice / Q000592:standards*; D005260:Female; D015577:Geriatric Assessment; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008485:Medical Audit; D009864:Ontario; D010808:Physical Examination; D019984:Quality Indicators, Health Care; D012189:Retrospective Studies