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Assessing, treating and preventing community acquired pneumonia in older adults: findings from a community-wide survey of emergency room and family physicians.
BMC Fam Pract. 2005 Aug 02; 6:32.BF

Abstract

BACKGROUND

Respiratory infections, like pneumonia, represent an important threat to the health of older Canadians. Our objective was to determine, at a community level, family and emergency room physicians' knowledge and beliefs about community acquired pneumonia (CAP) in older adults and to describe their self-reported assessment, management and prevention strategies.

METHODS

All active ER and family physicians in Brant County received a mailed questionnaire. An advance notification letter and three follow-up mailings were used to maximize physician participation rate. The questionnaire collected information about physicians' assessment, management, and prevention strategies for CAP in older adults (>or=60 years of age) plus demographic, training, and practice characteristics. The analysis highlights differences in approaches between office-based and emergency department physicians.

RESULTS

Seventy-seven percent of physicians completed and returned the survey. Although only 16% of physicians were very confident in assessing CAP in older adults, more than half reported CAP to be a very important health concern in their practices. In-service training for family physicians was associated with increased confidence in CAP assessment and more frequent use of diagnostic tests. Family physicians who reported always requesting chest x-rays were also more likely to request pulse oximetry (OR 5.6, 95% CI 1.40 to 22.5) and recommend both follow-up x-rays (OR 5.4, 95% CI 1.7 to 16.6) and pneumococcal vaccination (OR 3.4, 95% CI 1.1 to 10.0).

CONCLUSION

The findings of this study provide a snapshot of how non-specialists from a non-urban Ontario community assess, manage and prevent CAP in older adults and highlight differences between office-based and emergency department physicians. This information can guide researchers and clinicians in their efforts to improve the management and prevention of CAP in older adults.

Authors+Show Affiliations

St, Joseph's Health System Research Network, Father Sean O'Sullivan Research Centre, Hamilton, Ontario, Canada. kruegerp@mcmaster.caNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16076387

Citation

Krueger, Paul, et al. "Assessing, Treating and Preventing Community Acquired Pneumonia in Older Adults: Findings From a Community-wide Survey of Emergency Room and Family Physicians." BMC Family Practice, vol. 6, 2005, p. 32.
Krueger P, Loeb M, Kelly C, et al. Assessing, treating and preventing community acquired pneumonia in older adults: findings from a community-wide survey of emergency room and family physicians. BMC Fam Pract. 2005;6:32.
Krueger, P., Loeb, M., Kelly, C., & Edward, H. G. (2005). Assessing, treating and preventing community acquired pneumonia in older adults: findings from a community-wide survey of emergency room and family physicians. BMC Family Practice, 6, 32.
Krueger P, et al. Assessing, Treating and Preventing Community Acquired Pneumonia in Older Adults: Findings From a Community-wide Survey of Emergency Room and Family Physicians. BMC Fam Pract. 2005 Aug 2;6:32. PubMed PMID: 16076387.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Assessing, treating and preventing community acquired pneumonia in older adults: findings from a community-wide survey of emergency room and family physicians. AU - Krueger,Paul, AU - Loeb,Mark, AU - Kelly,Caralyn, AU - Edward,H Gayle, Y1 - 2005/08/02/ PY - 2005/03/07/received PY - 2005/08/02/accepted PY - 2005/8/4/pubmed PY - 2005/12/21/medline PY - 2005/8/4/entrez SP - 32 EP - 32 JF - BMC family practice JO - BMC Fam Pract VL - 6 N2 - BACKGROUND: Respiratory infections, like pneumonia, represent an important threat to the health of older Canadians. Our objective was to determine, at a community level, family and emergency room physicians' knowledge and beliefs about community acquired pneumonia (CAP) in older adults and to describe their self-reported assessment, management and prevention strategies. METHODS: All active ER and family physicians in Brant County received a mailed questionnaire. An advance notification letter and three follow-up mailings were used to maximize physician participation rate. The questionnaire collected information about physicians' assessment, management, and prevention strategies for CAP in older adults (>or=60 years of age) plus demographic, training, and practice characteristics. The analysis highlights differences in approaches between office-based and emergency department physicians. RESULTS: Seventy-seven percent of physicians completed and returned the survey. Although only 16% of physicians were very confident in assessing CAP in older adults, more than half reported CAP to be a very important health concern in their practices. In-service training for family physicians was associated with increased confidence in CAP assessment and more frequent use of diagnostic tests. Family physicians who reported always requesting chest x-rays were also more likely to request pulse oximetry (OR 5.6, 95% CI 1.40 to 22.5) and recommend both follow-up x-rays (OR 5.4, 95% CI 1.7 to 16.6) and pneumococcal vaccination (OR 3.4, 95% CI 1.1 to 10.0). CONCLUSION: The findings of this study provide a snapshot of how non-specialists from a non-urban Ontario community assess, manage and prevent CAP in older adults and highlight differences between office-based and emergency department physicians. This information can guide researchers and clinicians in their efforts to improve the management and prevention of CAP in older adults. SN - 1471-2296 UR - https://www.unboundmedicine.com/medline/citation/16076387/Assessing_treating_and_preventing_community_acquired_pneumonia_in_older_adults:_findings_from_a_community_wide_survey_of_emergency_room_and_family_physicians_ DB - PRIME DP - Unbound Medicine ER -