A pilot study of a computerized assessment (AGE-PC) for the elderly in general practice

A pilot project was undertaken in Liverpool UK, to investigatewhether data useful for both general practice and public healthpurposes could be collected by primary care personnel usinga computerized semi-structured interview (AGE-PC) for assessmentof patients aged 75 and over. A high degree of variation betweenpractices was found in the proportion of elderly assessed withAGE-PC largely related to motivation to undertake assessmentsand methods employed to approach patients. Considerable differencesbetween and within practices were evident in staff attitudesto the need for detailed formal assessments and the use of computers.Several aspects of the AGE-PC package itself were identifiedas requiring modification including streamlining data transfermethods, adding facilities for analysis and giving users a degreeof choice over content of the assessment. This technique doesoffer a potentially efficient means of collecting very detailedstandardized data for intra- or inter-practice analysis whileat the same time generating a comprehensive report for individualpatients. However, in the context of the over-75 assessmentsit was too time-consuming. Possible future strategies are discussedsuch as using an initial screening stage with a self-reportquestionnaire to reduce numbers needing full assessment andthe use of the package for the community care assessments. Thepilot project highlighted some of the potential advantages anddisadvantages of collecting data from primary health care forpublic health purposes. One of the most salient lessons learntwas the importance of involving the different team members inthe planning process so that there is agreement on: the essentialdata items required by both parties, the use of a uniform methodof approaching and sampling patients for assessments, the importanceof accuracy and obtaining a high response rate, and finallythat the whole procedure must be easy and not involve too muchtime or effort on the part of the overloaded primary care staff.