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Assessment of dizziness among older patients at a family practice clinic: a chart audit study

Eugene CK Kwong1* and Nicholas JG Pimlott1,2

Author Affiliations

1 Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada

2 Department of Family and Community Medicine, Women's College Campus, Sunnybrook and Women's College Health Sciences Center, 60 Grosvenor Street, Toronto, Ontario, M5S 1B6, Canada

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BMC Family Practice 2005, 6:2 doi:10.1186/1471-2296-6-2

Published: 6 January 2005

Abstract

Background

Dizziness is a common complaint among the elderly with a prevalence of over 30% in people over the age of 65. Although it is a common problem the assessment and management of dizziness in the elderly is challenging for family physicians. There is little published research which assesses the quality of dizziness assessment and management by family physicians.

Methods

We conducted a retrospective, chart audit study of patients with dizziness attending the Sunnybrook Family Practice Center of Sunnybrook and Women's College Health Sciences Center (SWCHSC) in Toronto. We audited a random sample of 50 charts of patients from 310 eligible charts. Quality indicators across all dizziness subtypes were assessed. These quality indicators included: onset and course of symptoms; symptoms in patients' own words; number of medications used; postural blood pressure changes; symptoms of depression or anxiety; falls; syncope; diagnosis; outcome; specialty referrals. Quality indicators specific to each dizziness subtype were also audited.

Results

310 charts satisfied inclusion criteria with 20 charts excluded and 50 charts were randomly generated. Documentation of key quality indicators in the management of dizziness was sub-optimal. Charts documenting patients' dizziness symptoms in their own words were more likely to have a clinical diagnosis compared to charts without (P = 0.002).

Conclusions

Documentation of selected key quality indicators could be improved, especially that of patients' symptoms in their own words.