Research conducted by Flinders’ Caring Futures Institute is shining a light on a glaring problem hidden in plain view – that premature early ageing of people is not receiving the proactive attention needed to improve their situation.
Surprising numbers of younger Australian adults are suffering from chronic conditions, frailty and dementia, but do not access necessary early medical attention focused on prevention.
“Our research aims to help improve the process of pro-active screening of ageing, particularly in areas of chronic disease, dementia and frailty,” explains Professor Stacey George, who has worked with Caring Futures Institute Research Fellow Dr Heather Block to implement improved screening routines among GPs. “The research shows that things can be done in a different way.”
The Caring Futures Institute team’s plan to increase the use of early intervention initiatives for healthy ageing in primary care was tested with 10 general practices in Adelaide. The GPs were encouraged to identify more patients with chronic disease, frailty and who show early signs of dementia. Promoting an increased use of proactive screening would then lead to the introduction of more preventative initiatives for these early-ageing patients through greater uptake of GP management plans.
The project results were surprising. Researchers found elevated numbers of people at an average age of 62 with multiple complications who were having up to 16 visits to GPs a year, and each having up to five co-morbid health problems being addressed.
“GPs are generally putting their focus on older people, but examining younger people for these health problems – between the ages of 40 to 70 – can provide prevention, rather than having to address more complex difficulties if they are first recognised later in a person’s life,” explains Dr Block.
“We recognise that GPs are extremely busy, but making them aware of this situation will hopefully prompt them to make early-ageing assessments of patients a part of their automatic checking steps when people come to visit GPs, and then get them on appropriate health plans earlier to address these issues.”
Through the research project, Professor George and Dr Block recorded an improved uptake of more than 500 patients by a cohort of 96 Adelaide GPs. Their research proves that GPs have the capacity to change outcomes for patients by introducing earlier treatment plans that will enable patients to have appointments bulk-billed.
Interestingly, a separate survey of almost 230 patients with an average age of 58 measured their quality of life – and they gave a subdued rating of only 72 out of 100. These people with early-ageing symptoms cited significant problems with pain management affecting their leisure activities or hobbies, and their independence.
“It showed that people not only needed a care plan, but also have more intervention-focused treatment,” says Dr Block. “With better management through comprehensive care planning that is coordinated by GPs, significantly improved help could be provided for these people – and improved awareness of early-ageing issues is the key.”
GP staff and patients were also interviewed by the Flinders team. Patients acknowledged that building a pleasant rapport with GPs is fundamental to patients trusting and fully utilising a GP practice – but staff also say better health service provision will only come through stronger links between GPs and a full network of associated local health professions, including allied health, while placing GPs as the lynchpin at the centre of this expansive health care circle.
The effectiveness of this Caring Futures Institute project has meant the program will be expanded to cover another 16 GP practices in Adelaide, and the researchers are confident that the positive results will encourage more pro-active screening of early ageing symptoms.
Taking action now is especially important, because Australia’s increasing aged population will also record increasing prevalence of chronic conditions, frailty and dementia – which, in turn, increases demand on health services and the burden on general practices.
“It’s not an impossible situation,” says Professor George. “Our research proves that if health providers have more people on effective treatment plans, this early identification really can make a big difference promoting health in people’s ageing process.”