Preventive Services Not Offered by Doctors at Annual Exams; Seniors Most Often Ignored
Docs mention about half of recommended preventive services to older patients; most recommended are tests for colorectal
cancer, hypertension, breast cancer
Jan. 26, 2012 - Patients – senior citizens and in particular – are not always presented with the screening tests and
counseling services that are recommended and due during their medical checkups. Those most likely to receive the preventive services were
those over-weight or obese.
According to a study, appearing in the upcoming issue of American Journal of Preventive Medicine, more than 20 percent of
U.S. adults visit their physicians each year for periodic health examination (PHEs)—an office visit intended for routine physicals and
screenings and discussions about risk factors and lifestyle habits.
Of the preventive health services due during the PHEs studied, just over
half were either recommended or delivered to patients.
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“Given how little the incentives and structure of the U.S. health care system support prevention, we considered this
percentage impressive,” said author Jennifer Elston Lafata, Ph.D., professor of social and behavioral health at Virginia Commonwealth
“What does and does not happen during a physician office visit is due to a mix of factors, including what the patient
needs and wants to address.”
The researchers captured audio recordings of 484 office visits by patients between the ages of 50 and 80 by 64 primary
care physicians over a 2-year period in southeast Michigan.
The goal was to see how often physicians delivered 19 national
guideline-recommended preventive services, such as screening tests for cancer and hypertension, counseling on tobacco and alcohol use, and
immunizations to patients who were eligible and due.
Of the 2,662 services due during those visits, 54 percent were delivered. Those most likely to be given were screening
tests for colorectal cancer (92.9 percent), hypertension (92 percent), and breast cancer (88.9 percent).
“I believe with the widespread use of electronic health records and new delivery models of care we can increase the
percentage,” said Charles Cutler, M.D., a practicing internist in Norristown, Pa.
“Team-based care with each member providing services based on his or her level of education is ideally designed to have
all patients receive all the preventative and screening services now recommended by national guidelines.”
Lafata and her colleagues also found patients were least likely to receive counseling about aspirin use, diet, flu
immunization and vision screening. And the likelihood that patients were delivered recommended services decreased with the patients’ age and
increased with higher body mass indexes (BMI).
“My hunch is that patients with higher BMIs probably are more likely to seek medical treatment, since they are likely to
have one or more [chronic] medical conditions,” suggested Cutler. “Once being treated for these conditions, an obese patient would seemingly
be more likely to be offered screening for preventive disorders.”
> Original report by Glenda Fauntleroy, Contributing Writer, Health Behavior News Service
> Research Source: American Journal of Preventive Medicine