title: Barriers to and promoters of screening for falls in elderly community-dwelling patients by general practitioners: a large cross-sectional survey in two areas of France.
abstract: The objective was to determine the factors affecting French GPs' implementation of annual screening for falls among patients of 75 years old and over. We conduct a cross-sectional study in two areas in the South-east of France (Savoie and Isère). An anonymized survey was sent by e-mail and/or post in May 2008 to all GPs with a large practice. Reminder letters were sent to GPs who hadn't answered between June and July 2008. Potentials barriers were measured by dichotomous scale. On GPs characteristics (socio-demographic, knowledge, attitude and practice), a multiple logistic regression was performed to identify others factors affecting falls screening. 493 questionnaires were analyzed (26.8%). 65.3% of respondents considered annual screening for falls to be useful, though only 28.8% of them implemented it each year and 9.3% every two to five years. Barriers to achieving annual screening included patient selecting (56.3%), forgetting to screen (26.6%), unsuitable working conditions (18.5%), lack of time (13.3%), of knowledge (13.3%), or of financial compensation (11.1%). Perception of the usefulness of annual screening for falls (OR=5.38 (2.07-14.08); p=0.001), satisfaction with medical care for falls (OR=1.34 (1.09-1.65); p=0.006) and increased consultation time (OR=2.65 (1.37-5.13); p=0.004), were found to have a significant impact on the implementation of annual screening for falls. Asking your patient each year if s/he has had any falls, inquiring about gait and balance disturbance is not time consuming. Finally, to improve a health-related quality of life, GPs should consider fall assessment as a fundamental feature of medical care.
authors.affiliation: Univ. Grenoble Alpes, TIMC-IMAG, F-38000 Grenoble, France; Département de Médecine Générale, Faculté de Médecine de Grenoble, avenue des Marquis du Grésivaudan, 38706 La Tronche Cedex, France; CNRS, TIMC-IMAG, F-38000 Grenoble, France; Inserm CIC 1406, F-38000 Grenoble, France. Electronic address: yoann.gaboreau@ujf-grenoble.fr.
authors.forename: Yoann
authors.initials: Y
authors.lastname: Gaboreau
authors.affiliation: Univ. Grenoble Alpes, TIMC-IMAG, F-38000 Grenoble, France; Département de Médecine Générale, Faculté de Médecine de Grenoble, avenue des Marquis du Grésivaudan, 38706 La Tronche Cedex, France; CNRS, TIMC-IMAG, F-38000 Grenoble, France; Inserm CIC 1406, F-38000 Grenoble, France. Electronic address: patrick.imbert@ujf-grenoble.fr.
authors.forename: Patrick
authors.initials: P
authors.lastname: Imbert
authors.affiliation: Univ. Grenoble Alpes, TIMC-IMAG, F-38000 Grenoble, France; Département de Médecine Générale, Faculté de Médecine de Grenoble, avenue des Marquis du Grésivaudan, 38706 La Tronche Cedex, France. Electronic address: jp.jacquet@ujf-grenoble.fr.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Jacquet
authors.affiliation: Univ. Grenoble Alpes, TIMC-IMAG, F-38000 Grenoble, France; Département de Médecine Générale, Faculté de Médecine de Grenoble, avenue des Marquis du Grésivaudan, 38706 La Tronche Cedex, France. Electronic address: guillaume.de-vericourt@ujf-grenoble.fr.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Royer De Vericourt
authors.affiliation: Univ. Grenoble Alpes, TIMC-IMAG, F-38000 Grenoble, France; Clinic of Geriatrics, University medical center of Grenoble, Avenue des Marquis du Grésivaudan, 38706 La Tronche, France. Electronic address: pcouturier@chu-grenoble.fr.
authors.forename: Pascal
authors.initials: P
authors.lastname: Couturier
authors.affiliation: Univ. Grenoble Alpes, TIMC-IMAG, F-38000 Grenoble, France; Clinic of Geriatrics, University medical center of Grenoble, Avenue des Marquis du Grésivaudan, 38706 La Tronche, France. Electronic address: ggavazzi@chu-grenoble.fr.
authors.forename: Gaëtan
authors.initials: G
authors.lastname: Gavazzi
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data; D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D005194:Family Practice; D005260:Female; D005602:France / Q000453:epidemiology; D015577:Geriatric Assessment / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000592:standards*; D008875:Middle Aged; D018579:Patient Selection; D011788:Quality of Life; D013997:Time Factors; D017132:Workplace / Q000592:standards
keywords: Accidental fall; Elderly; General practice; Mass screening; Primary care