GP concordance with advice for treatment following a multidisciplinary psychogeriatric assessment.
OBJECTIVE
To evaluate the concordance of General Practitioners (GPs) with advice for treatment after a multidisciplinary psychogeriatric assessment by the Diagnostic Observation Centre for PsychoGeriatric patients (DOC-PG).


METHODS
Concordance checklists, listing the recommendations from the multidisciplinary team, were sent to the GPs in order to establish GP concordance. Regression models were used to study the associations between various patient and GP characteristics and level of concordance. Furthermore, results of a questionnaire (to identify the level of satisfaction regarding the services provided by the DOC-PG) were compared with the level of GP concordance.


RESULTS
Based on 530 recommendations, the overall GP concordance rate amounted to 71%. The most common types of advice pertained to medication, GP follow-up/advice and referral. GP concordance with advice regarding admissions was the highest, followed by advice concerning the arrangement of daycare, home care and the adaptation of medication. GP concordance was lowest for referral recommendations to other specialties and recommendations regarding psychoeducation. Concordance was higher for patients who lived alone, for patients with fewer cognitive problems, when the number of recommendations did not exceed six and in group practices. Concordance was dependent on the type of advice. Satisfaction with DOC-PG did not correlate with the level of concordance.


CONCLUSIONS
In general, GPs showed a high level of concordance with advice from the DOC-PG. Enhancement of GP concordance can be achieved by limiting the number of recommendations, giving detailed explanations about the purpose of recommendations and educating GPs by doing.
Wolfs
Claire A G
CA
Department of Clinical Epidemiology and Medical Technology Assessment, University Hospital of Maastricht, Maastricht, The Netherlands.
Verhey
Frans R J
FR
Kessels
Alfons
A
Winkens
Ron A G
RA
Severens
Johan L
JL
Dirksen
Carmen D
CD
D000368:Aged; D000369:Aged, 80 and over; D005194:Family Practice; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000628:therapy*; D008875:Middle Aged; D009426:Netherlands; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis