A RANDOMIZED TRIAL OF OFFICE-BASED SCREENING FOR COMMON PROBLEMS IN OLDER PERSONS

PURPOSE: To test the effectiveness of a 10-minute office-staff adminis tered screen to evaluate malnutrition/weight loss, visual impairment, hearing loss, cognitive impairment, urinary incontinence, depression, physical limitations, and reduced leg mobility among older persons see n in office practice. This screen was coupled with clinical summaries to assist the physician in further evaluating and managing the screen- included problems. PATIENTS AND METHODS: Twenty-six community-based of fice practices of internists and family physicians in Los Angeles were randomized to intervention or control groups. Two hundred and sixty-o ne patients aged greater than or equal to 70 years and seeing these ph ysicians for a new visit or a physical examination participated in the study. At the enrollment visit intervention group patients were admin istered the screening measure and their physicians were given the pert inent clinical summaries. Outcome measures were detection of, and inte rvention for conditions screened, and health status 6 months after the intervention. RESULTS: Hearing loss was both more commonly detected ( 40% intervention versus 28% control) and further evaluated (29% versus 16%) by physicians in the intervention group (P <0.05). No other diff erences in the frequency of problem detection or intervention were not ed between groups. Six months after the intervention no differences we re noted in health status between groups. CONCLUSIONS: A brief measure to screen for common conditions in older persons was associated with more frequent detection and follow-up assessment of hearing loss. Alth ough the measure was well accepted by physicians and their staffs, it did not appear to affect detection and intervention in regard to the o ther screen-included conditions, or health status at 6 months. (C) 199 7 by Excerpta Medica, Inc.