Implementation of a brief anxiety assessment and evaluation in a Department of Veterans Affairs geriatric primary care clinic.
Anxiety disorders are common and debilitating in older individuals, yet anxiety is often not formally assessed in primary care. We conducted a quality improvement project to examine the feasibility of implementing a brief anxiety assessment, the Geriatric Anxiety Inventory (GAI), in a Department of Veterans Affairs geriatric primary care clinic. We compared the GAI with a depression assessment, the 15-item Geriatric Depression Scale (GDS-15). Fifty older Veterans (mean = 78.5 +/- 7.4 yr) completed the GAI and GDS-15. Mean completion time and feedback to patients was brief (6.20 min; n = 10). Good internal consistency (alpha = 0.82) was found for GAI scores. Patients with psychiatric diagnoses obtained significantly higher GAI scores (mean = 4.73 +/- 1.15) compared with patients without psychiatric diagnoses (mean = 1.15 +/- 1.86, t(11.46) = -3.10, p = 0.01). Findings suggest that the GAI is acceptable to patients but may not be suitable for differentiating anxiety symptoms or disorders from depression. Interdisciplinary team members continued to implement the GAI after project completion to screen for and track anxiety symptoms in our geriatric primary care patients. Detecting anxiety with the GAI had the benefit of allowing providers to initiate conversations about available treatments and track symptoms as part of noting treatment progress.
Geriatric Research Education and Clinical Center, Department of Veterans Affairs Palo Alto Health Care System, Palo Alto, CA;
Christine E
CE
Gould
Sherry A
SA
Beaudreau
Gail
G
Gullickson
J Lisa
JL
Tenover
Elizabeth A
EA
Bauer
J W Terri
JW
Huh
D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000175:diagnosis*; D003863:Depression / Q000175:diagnosis*; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D011320:Primary Health Care; D058996:Quality Improvement; D014728:Veterans
Veteran; anxiety disorder; anxious; depression; mental health; older adults; program evaluation; psychiatric; quality improvement; screening