The authors have no conflict of interest to declare for this article.
Perceptions of Physicians on the Barriers and Facilitators to Integrating Fall Risk Evaluation and Management Into Practice
Article first published online: 7 DEC 2005
Journal of General Internal Medicine
Volume 21, Issue 2, pages 117–122, February 2006
How to Cite
Chou, W. C., Tinetti, M. E., King, M. B., Irwin, K. and Fortinsky, R. H. (2006), Perceptions of Physicians on the Barriers and Facilitators to Integrating Fall Risk Evaluation and Management Into Practice. Journal of General Internal Medicine, 21: 117–122. doi: 10.1111/j.1525-1497.2005.00298.x
This research was presented at the Gerontological Society of America Annual Conference, Washington, DC, November 21, 2004.
- Issue published online: 8 MAR 2006
- Article first published online: 7 DEC 2005
- Manuscript received April 12, 2005 Initial editorial decision June 21, 2005 Final acceptance September 8, 2005
- qualitative research;
- primary care
Background: Falls are common, treatable, and result in considerable morbidity in older adults. However, fall risk factor evaluation and management targeted at high-risk patients is largely neglected in clinical practice.
Objective: To identify barriers and facilitators to the implementation of fall risk management by primary care providers.
Design: Qualitative study using a semi-structured interview.
Participants: Primary care providers who received an academic outreach visit.
Approach: Self-reported facilitators and barriers to evaluating and managing fall risk in older patients.
Results: Physician factors, logistical factors, and patient factors intersect to either facilitate or impede fall risk evaluation and management by primary care providers. Physician factors include awareness, competing risks, appropriateness of referrals, training, and tie-in to familiar activities. Logistical factors include availability of transportation, time requirements of immobile patients, reimbursement, scheduling, family involvement, and utilization of other health care providers. Physicians' perceptions of patient factors include reporting, attitudes toward medication, and positive feedback.
Conclusion: Strategies to improve the adoption of fall risk evaluation and management in primary care should address the specific physician, logistical, and patient barriers perceived by physicians who had received an informative, motivational intervention to assess and manage falls among their patients.