Prevalence and Correlates of Doctor-geriatric Patient Lifestyle Discussions : Analysis of ADEPT Videotapes

Marcia G. Ory, Paula J. Yuma, Paula J. Yuma, Margo-Lea Hurwicz, Margo-Lea Hurwicz, Crystal Jarvis, Crystal Jarvis, Kate L. Barron, Tom Tai-Seale, Ming Tai-Seale, Dhaval Patel, Dhaval Patel, David Hackethorn, David Hackethorn, Rachel Bramson, Rachel Bramson, Richard Street, Mary Ann Cook

Research output: Contribution to journalArticlepeer-review

Abstract

Background
This study identifies the prevalence and correlates of physician–geriatric patient discussions about physical activity and  nutrition  lifestyle behaviors.
Methods
Between August 1998 and July 2000, 423 older patient visits to 36 physicians were videotaped in three different primary care settings. The patient sample was primarily white, female, well-educated, and financially sufficient, although 12.7% of the encounters occurred in an inner city clinic. The major dependent variable–lifestyle discussion–is based on observations of physician behavior. Descriptive and multivariate  logistic regression  analyses were conducted in 2004.
Results
Nutrition talk was most prevalent, occurring in almost half the encounters (48.2%) followed by physical activity discussions (39.2%) then conjoint mention (22%). Discussions were significantly less likely to occur in acute visits. While ethnicity, gender, and length of visit were not significantly related, physician interaction style and patient vitality and education were significant predictors in the multivariate analyses.
Conclusions
Given the impact of lifestyle behaviors on myriad health outcomes, the current prevalence rates of physician discussion, while higher than in many previous studies, remain sub-optimal. Practical assessment tools, training in behavioral counseling, and  reimbursement incentives  are recommended strategies for raising physical activity and nutrition discussion prevalence in primary care settings.
Original languageAmerican English
JournalPreventive Medicine
Volume43
DOIs
StatePublished - Dec 1 2006

Keywords

  • Doctor–patient encounters
  • Geriatric patients
  • Lifestyle behaviors

Disciplines

  • Physical Therapy
  • Medicine and Health Sciences
  • Multivariate Analysis

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