Abstract
Studies of health care services and older adults’ well-being represent a critically important topic in applied gerontology research. Health services research seeks to identify ways to effectively manage chronic conditions and to screen for warning signs to initiate treatment early, preventing progression to more serious conditions. This month’s issue of Journal of Applied Gerontology includes six articles addressing primary care, prevention and recovery, prescription drug abuse and use of graphical visualization of health data.
The first two articles report results of qualitative studies interviewing primary care providers. Hoff and DePuccio aimed to identify implementation gaps for seniors in patient-centered medical homes (PCMH). They found gaps related to assessment, links to community resources, and care coordination and discussed a range of responses to these gaps by PCMH practices. In Davis and colleagues’ article, primary care providers share their perspectives on HIV prevention strategies for older adults. Findings point to a need to increase HIV prevention efforts in this population and provide specific recommendations for strategies they think will be successful, such as electronic reminders for providers to talk to older patients about HIV prevention.
The third article in this issue examines whether middle aged and older adults’ experience of health shocks or health scares leads to behavior change. Specifically, Ng and Jensen analyzed 10 years of data from the Health and Retirement Study and found that participants who experience an adverse health event are significantly more likely to start using a wide range of preventive services, such as cancer screenings, cholesterol checks, and flu shots. The authors suggest that education regarding the need for preventive screening and making such services available in non-clinical settings may increase uptake of these important services.
Hajduk and coauthors’ article moves the focus to support received after hospitalization for acute coronary syndrome (ACS), when patients are expected to initiate new self-care routines and learn how to manage their illness to prevent future events. They examine the support resources reported by patients in the TRACE-CARE study, conducted in Massachusetts and Georgia. Two thirds of participants reported needing help during the first week after discharge and 81% reported receiving instrumental and/or informational support. However, the authors identify subgroups of patients who lack needed support. The study also underlines the key role of caregivers, noting they should be included as partners in discharge education and discussion of disease management.
The last two articles in this special issue detail tools for researchers and for older adults seeking to maintain health and wellness. Pope and colleagues note the important role of the aging services network in addressing the increasing problem of prescription drug misuse and abuse among older adults. The article reports on the development and psychometric testing of the Prescription Drug Assessment Questionnaire, which assesses geriatric case managers’ knowledge, attitudes, and behaviors regarding older adults’ prescription drug use, as a necessary precursor for developing interventions to address this problem. Finally, Le and coauthors describe their work in creating health data visualizations, or graphical displays, that resonate with older adults. They worked closely with a group of older adults to identify how older adults would want to use such health data visualizations and what features or supports they would need to make these tools relevant and useful for maintaining overall wellness.
As a group, these six articles touch on all three categories of prevention: primary prevention such as education, secondary prevention such as screening, and tertiary prevention such as managing chronic conditions to prevent disability. These articles together provide an overview of applied gerontology research on health care services aiming to optimize health and well-being for older adults.