Preventive care of older urban American Indians and Alaska natives in primary care

Journal of General Internal Medicine
D BuchwaldS Manson

Abstract

Little is known about prevention among elderly or urban American Indian/Alaska Native (AI/AN) populations. We reviewed the medical records of 550 older urban AI/AN primary care patients to evaluate how frequently preventive measures were received. Adherence to guidelines was examined by a culturally appropriate (> or =50 years) and standard age threshold (> or =65 years), and by performance of preventive measures at any time ("ever") and in the past year. Lifetime performance was inadequate for the many measures, including mammograms (56%), fecal occult blood testing (37%), audiometry (33%), visual acuity testing (50%), smoking cessation counseling (50%), and pneumococcal (22%) and influenza (49%) vaccinations. Performance of the measures was less frequent in the prior year, but did not differ by age threshold. Predictors of adherence included female gender, having insurance, and having more health problems and medications. Nonadherence infrequently resulted from patients' failure to comply with recommendations. We conclude that use of most preventive services among elderly urban AI/ANs is suboptimal and should be improved.

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Citations

Nov 1, 2005·American Journal of Public Health·Thomas D SequistJohn Z Ayanian
Aug 10, 2004·The Journal of Rural Health : Official Journal of the American Rural Health Association and the National Rural Health Care Association·Alfred BryantDedra Buchwald
May 22, 2003·Journal of the American Geriatrics Society·Dorothy A Rhoades, Dedra Buchwald

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