How Finnish geriatricians perform comprehensive geriatric assessment in clinical practice?

Abstract

IntroductionComprehensive geriatric assessment (CGA) is one of the most important evaluation tools in geriatrics, but there is variability in its use in different clinical settings. In this study we aimed to clarify how Finnish geriatricians apply CGA in their clinical practice. MethodsWe organized a web-based survey among the members of Finnish Geriatricians (n=248). The questionnaire included items about use and content of CGA. The evaluated domains were assessment of cognition, nutrition and functional ability, evaluation of depression, and measurement of orthostatic blood pressure. ResultsAltogether 121 physicians (49%) responded, and the present analysis included 95 geriatricians performing clinical work. Majority of the respondents (94%) used CGA. Of them, 38% performed CGA to all new patients and 62% to selected patients only. Ten respondents (11%) incorporated all five domains into CGA whereas others selected domains according to their clinical judgment. Greater proportion of female than male physicians included evaluation of depression (39% vs. 16%, P=0.045) and assessment of functional ability (48% vs. 24%, P=0.01) always in CGA. Respondents, who applied CGA to all new patients, incorporated nutritional assessment (68% vs. 34%, P=0.002) and measurement of orthostatic blood pressure (76% vs. 54%, P=0.04) always into CGA more often than those who performed CGA to selected patients only. Respondents’ working conditions were not associated with the application of CGA. ConclusionsMajority of the respondents performed CGA to their patients. The content of CGA varied between geriatricians. Incomplete evaluation may lead to inadequate detection of geriatric syndromes and other problems.