Screening the elderly in general practice

All the 855 patients over the age of 65 in one general practice were reviewed. Those under care were excluded (316—37 per cent), and the rest were offered a screening examination in the practice. In all, 335 were examined and several had been previously screened. The yield of conditions found is reported and the advantage of the work in general practice discussed.     

Minimum data set necessary to promote the care of the elderly in general practice

A preliminary data set was designed to allow uniform information collection, to initiate structured intervention and thereby to promote anticipatory care of the elderly. A questionnaire inviting comment on the data set was sent to 116 general practitioners in training practices and 40 consultants in geriatric medicine in the northern region and also to the 18 professors in general practice in the United Kingdom. The response rates from the three groups were 76%, 55% and 67% respectively.

There was good agreement between the three groups regarding the content of the data set suggesting that it may be possible to introduce uniform information collection which in turn would standardize records of the elderly and aid computerization.

The need for periodic screening of the elderly was considered necessary by 37% of general practitioners, 59% of consultants and 33% of professors. The cause of such low interest in screening and its effect on computerized care and surveillance of the elderly are discussed.

     

Preventive care card for general practice.

A new preventive care card for use in general practice has been designed and produced by a working party of general practitioners from the local medical committees of Devon and Cornwall and the Tamar faculty of the Royal College of General Practitioners. The new card, which is described in this paper, is proposed as a replacement for forms FP7A and FP8A in general practice records.     

Development of guidelines for general practice care.

The setting of standards for general practice care is receiving increasing attention in many countries. However, various problems have been noted in the procedures used for the development of guidelines. In this paper, a model for developing guidelines that fit into the specific general practice situation is presented. This model attempts to integrate current experiences in this area. Ideally, the development of guidelines should take place on various levels (central, local, practice and individual), each level involving different aims and methods. Thorough procedures must be used, in which attention is paid to the scientific validity of the guidelines, the reliability of the results, the clinical applicability, and in particular, the acceptance and adoption of the guidelines in practice.