Objective: The Partners in Care project is a multi-site study investigating potential for service improvement in elderly patient care through the integration of social workers into primary care teams.
Design: Since June 2000, approximately 2,150 adult patients, from 11 sites in Chicago and downstate Illinois, have consented to a series of 45-minute screening interviews consisting of the Geriatric Depression Scale (GDS), Mini Mental Status Evaluation (MMSE), Seven-Minute Screen (7MS), Medical Outcomes Short Form, Lawton Activities of Daily Living, Hassles Scale, and others. In the seven treatment sites, patients who screen positive for depression, sleep, medication management, frequent falls, and cognitive problems are signaled for social worker interventions. At the four control sites, there are no social workers. At all 11 sites, primary care physicians are notified when a participant screens positively as a signal case.
Materials and Methods: The present analyses include data from 2,150 primary care patients age 65 or older who completed a baseline Seven-Minute Screen (7MS, Solomon, P.R., et. al., 1998) and Mini Mental Status Exam (MMSE) as part of the project.
Results: Although the cognitive screening instruments suggested that as many as 28% of elderly primary care patients show symptoms consistent with cognitive impairment, it is likely that none of these symptoms will be noted in their primary care charts. Only 5.6% of study patients had any symptoms of cognitive impairment noted, and among those testing positive on either cognitive impairment screen, only 11.3% had any symptoms of cognitive impairment noted in charts. Only 1.7 % (less than 8% of those with cognitive impairment by screen) were on cognitive enhancers.
Conclusion: Few patients who screen positive for cognitive impairment are documented as such in primary care physician’s notes, and even fewer receive pharmacologic treatment intervention. Any changes over the course of a 12-month period of intervention will be presented.
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