title: A geriatric assessment in general practice: prevalence, location, impact and doctor-patient perceptions of pain.
abstract: BACKGROUND
  To investigate what a geriatric assessment in general practice adds towards previous findings of prevalence, location, impact and the dyadic doctor-patient perception of pain in this age group.
  
  
  METHODS
  Cross-sectional study. Consecutive patients aged 70 and over underwent a comprehensive geriatric assessment in general practice that included a basic pain assessment (severity, sites and impact). Patients with pain and their doctors then independently rated its importance. Pain was correlated with further findings from the assessment, such as overall health, physical impairments, everyday function, falls, mood, health related lifestyle, social circumstances, using bivariate and multivariate statistics. Patient-doctor agreement on the importance of pain was calculated using kappa statistics.
  
  
  RESULTS
  219 out of 297 patients (73.7 %) reported pain at any location. Pain was generally located at multiple sites. It was most often present at the knee (33.9%), the lumbar spine (33.5%) as well as the hip (13.8%) and correlated with specific impairments such as restrictions of daily living (knee) or sleep problems (spine). Patients with pain and their physicians poorly agreed on the importance of the pain problem.
  
  
  CONCLUSIONS
  A basic pain assessment can identify older patients with pain in general practice. It has resulted in a high prevalence exceeding that determined by encounters in consultations. It has been shown that a geriatric assessment provides an opportunity to address pain in a way that is adapted to older patients' needs - addressing all sites, its specific impact on life, and the patients' perceived importance of pain. Since there is little doctor-patient agreement, this seems a valuable strategy to optimize concrete treatment decisions and patient centered care.
  
  
  BACKGROUND
  This study is registered in the German Clinical Trial Register ( DRKS00000792 ).
authors.affiliation: Institute of General Practice, Hannover Medical School, Carl-Neuberg-Str.1, 30625, Hannover, Germany. kruschinski@yahoo.de.
authors.forename: Carsten
authors.initials: C
authors.lastname: Kruschinski
authors.affiliation: Institute of General Practice, Hannover Medical School, Carl-Neuberg-Str.1, 30625, Hannover, Germany. wiese.birgitt@mh-hannover.de.
authors.forename: Birgitt
authors.initials: B
authors.lastname: Wiese
authors.affiliation: Institute of Epidemiology, Public Medicine and Healthcare Systems Research, Hannover Medical School, Hannover, Germany. dierks.marie-luise@mh-hannover.de.
authors.forename: Marie-Luise
authors.initials: ML
authors.lastname: Dierks
authors.affiliation: Department of General Practice, University Medical Centre, Göttingen, Germany. eva.hummers-pradier@med.uni-goettingen.de.
authors.forename: Eva
authors.initials: E
authors.lastname: Hummers-Pradier
authors.affiliation: Institute of General Practice, Hannover Medical School, Carl-Neuberg-Str.1, 30625, Hannover, Germany. schneider.nils@mh-hannover.de.
authors.forename: Nils
authors.initials: N
authors.lastname: Schneider
authors.affiliation: Institute of General Practice, Hannover Medical School, Carl-Neuberg-Str.1, 30625, Hannover, Germany. junius-walker.ulrike@mh-hannover.de.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Junius-Walker
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D005260:Female; D058006:General Practice; D015577:Geriatric Assessment; D006304:Health Status; D006801:Humans; D008297:Male; D010146:Pain / Q000175:diagnosis* / Q000453:epidemiology; D058748:Pain Perception; D015995:Prevalence; D017678:Sex Distribution
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