Compliance With Recommendations From an Outpatient Geriatric Consultation Team

For outpatient geriatric consultation to be effective, it is necessary, although not sufficient, that recommendations made to patients are followed. This prospective cohort study describes the nature of, types of, and compliance with, recommendations made to patients by clinicians at a university-based outpatient geriatric clinic. All patients seen by an internal medicine physician or family practitioner were contacted 1 year following their initial visit to determine compliance with recommendations. Clinicians identified 4.6 problems per patient; more than one half had never been documented previously. The most common problems were medical (53.1%) and neuropsychiatric (26.7%). Patients had substantial limitations in both instrumental (XBAR = 2.3) and physical (XBAR = 1.3) activities of daily living. Clinicians made 5.9 recommendations per patient, 67.1% of which were followed. Compliance was similar for medical and social recommendations. No predictors of compliance were identified. Practitioners need to be aware that one third of their recommendations are not followed, and characterizing patients at increased risk for noncompliance is difficult.