Abstract
BackgroundDizziness is a common complaint among the elderly with a prevalence of over 30% in people over the age of 65. Although it is a common problem the assessment and management of dizziness in the elderly is challenging for family physicians. There is little published research which assesses the quality of dizziness assessment and management by family physicians.MethodsWe conducted a retrospective, chart audit study of patients with dizziness attending the Sunnybrook Family Practice Center of Sunnybrook and Women's College Health Sciences Center (SWCHSC) in Toronto. We audited a random sample of 50 charts of patients from 310 eligible charts. Quality indicators across all dizziness subtypes were assessed. These quality indicators included: onset and course of symptoms; symptoms in patients' own words; number of medications used; postural blood pressure changes; symptoms of depression or anxiety; falls; syncope; diagnosis; outcome; specialty referrals. Quality indicators specific to each dizziness subtype were also audited.Results310 charts satisfied inclusion criteria with 20 charts excluded and 50 charts were randomly generated. Documentation of key quality indicators in the management of dizziness was sub-optimal. Charts documenting patients' dizziness symptoms in their own words were more likely to have a clinical diagnosis compared to charts without (P = 0.002).ConclusionsDocumentation of selected key quality indicators could be improved, especially that of patients' symptoms in their own words.
Highlights
Dizziness is a common complaint among the elderly with a prevalence of over 30% in people over the age of 65
Dizziness is a common complaint among the elderly, with a prevalence of more than 30% in people over age 65 [1] and it accounts for 2% of consultations in the primary care setting [2]
There are more females than males among the patients with lightheadedness (30% vs. 10%) and vertigo (16% vs. 10%) whereas the ratio of females to males is roughly the same among those with dysequilibrium (20% vs. 18%). 30% (n = 15) of patients presented with more than one subtype of dizziness
Summary
Dizziness is a common complaint among the elderly with a prevalence of over 30% in people over the age of 65. Dizziness is a common complaint among the elderly, with a prevalence of more than 30% in people over age 65 [1] and it accounts for 2% of consultations in the primary care setting [2]. Reported frequencies of specific diagnoses for dizziness varies widely depending on: 1) clinical setting (primary care setting, referral center or emergency department); 2) patient age or patient populations examined; and 3) investigator bias. These methodological problems limit the generalizability of the etiological studies [3]. Kroenke et al [7] found in (page number not for citation purposes)
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