COMPLIANCE WITH SOCIAL AND SAFETY RECOMMENDATIONS IN AN OUTPATIENT COMPREHENSIVE GERIATRIC ASSESSMENT PROGRAM

Background. A unique contribution of a comprehensive outpatient geriat ric assessment is its focus on social and safety issues in the frail e lderly. The impact of such programs depends on the caregiver and/or pa tient complying with safety and social recommendations offered by the assessment team. Compliance in this setting has not been previously de scribed. Methods. A telephone survey was conducted of self-reported co mpliance in 124 frail geriatric patients with a high prevalence of dem entia 3-21 months after completing a comprehensive geriatric assessmen t program at the University of California, San Diego, Medical Center. Results. The social and safety recommendations constituted 52.8% of al l the recommendations offered. The overall compliance rate (total numb er of safety and social recommendations followed/total number offered x 100) was 50.2% (95% CI: 43.7-56.6). Highest compliance was achieved with recommendations to complete a prior directive for health care (80 .6%) and to wear a medic-alert bracelet (57.5%). Patients complied poo rly with recommendations to change a living situation (36.2%). Analysi s of variance showed compliance to increase with time between the asse ssment and survey. Stratifying for time, we found higher compliance in patients with greater impairment in functional or cognitive status. M ost noncompliance was due to disagreement with the recommendations off ered or failure to implement acceptable recommendations. Conclusions. Compliance with social and safety recommendations offered in a compreh ensive geriatric assessment program approximates compliance observed i n other clinical settings. In this setting compliance increases over t ime. When controlled for time, impairment in functional or cognitive s tatus is associated with greater compliance.