A SYSTEMATIC REVIEW OF KNOWLEDGE OF PHYSICIANS ABOUT ABUSE OF OLDER ADULTS

Abstract

Introduction Elder abuse is a global problem that is many at times under-recognized. This can have significant consequences to physical and mental health of older adults. Physicians play a key role in identifying and reporting elder abuse. If not promptly identified, it can lead to a delay in medical and psychological management of such patients. The objective of this systematic review is to review literature about knowledge of physicians about elder abuse. Methods The databases of Pubmed, Google Scholar and Scopus were used by the authors to search for literature. The keywords used for the search were: knowledge, physicians, elder abuse and elder mistreatment. Studies were included in the review if they had been published in an English-language, peer-reviewed journal. Data extracted included aim, study design, country of study, year of publication of the study, sample size, response rate, specialty of the physician and main findings of the study. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used to report the findings. The quality of evidence was assessed using Grading of Recommendations, Assessment, Development and Evaluations (GRADE). Results 72 papers were identified in initial search. After removing duplicates and assessing abstracts and full articles against the inclusion criteria, 25 articles were included in the review. The studies comprised of descriptive studies. The year of publication ranged from 1989 to 2019. Majority of the studies were conducted on primary care physicians (N=12) and were from USA (N=9). One study used the Knowledge and Management of Elder Abuse questionnaire and the remaining studies employed a self-reported questionnaire. 2 studies used a medical educational video and one study used a lecture on elder abuse as an intervention and conducted a pre and post analysis following the interventions (N=3) . The studies showed low knowledge of elder abuse including laws and regulations (14%- 79.2%). This improved in studies using interventions (60%-75%). Lack of training and understanding of reporting mechanism were found to be the barrier in gaining knowledge of elder abuse by physicians.The level of evidence as qualified with GRADE was medium to low. All the studies had limitations of selection bias. Conclusions Our review suggests that there is a gap in knowledge of elder abuse amongst physicians around the world. The number of studies that have used interventions to improve knowledge are limited which needs to be addressed with further studies. The medical and residency training in various specialties should include a curriculum to improve knowledge about elder abuse to improve identification and management of elder abuse. This research was funded by: Not applicable