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

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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 (≥50 years) and standard age threshold (≥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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Authors and Affiliations

  1. Received from the Department of Medicine, University of Washington, Seattle, Wash

    Dedra Buchwald MD, Richard Furman MA & Suzanne Ashton BA

  2. the Department of Psychiatry, University of Colorado Health Sciences Center, Denver, Colo

    Spero Manson PhD

Authors
  1. Dedra Buchwald MD
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  2. Richard Furman MA
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  3. Suzanne Ashton BA
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  4. Spero Manson PhD
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Corresponding author

Correspondence to Dedra Buchwald MD.

Additional information

Supported in part by grants 1P30AG/NE15292 from the National Institute of Aging and the National Institute of Nursing Research, 90-AM-0757 from the Administration on Aging to Drs. Buchwald and Manson, and P0143471 from the National Institute of Mental Health to Dr. Manson.

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Buchwald, D., Furman, R., Ashton, S. et al. Preventive care of older urban American Indians and Alaska Natives in primary care. J GEN INTERN MED 16, 257–261 (2001). https://doi.org/10.1046/j.1525-1497.2001.016004257.x

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  • DOI: https://doi.org/10.1046/j.1525-1497.2001.016004257.x

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