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Table 2 The brief assessment questionnaire areas, specified in the GP contract and corresponding questions

From: The MRC trial of assessment and management of older people in the community: objectives, design and interventions [ISRCTN23494848]

Area

Questions

Response scale and trigger

Social Environment

Social support

 
 

Living circumstances Carer for someone else at home Someone to call on for help Frequency of social contacts

Live alone or is carer and nobody to call on for help or rarely sees relatives/friends

 

Self care

 
 

Wash all over

Unable and no help

 

Get dressed

Unable and no help

 

Cut toe nails

Unable and no help

 

Cook hot meal

Unable and no help

 

Do light housework or simple repairs

Unable and no help

 

Financial problems

 
 

Difficulty keeping home warm

Often or always

 

Problems in making ends meet

Always

Sensory impairment

Difficulty hearing

A lot

 

Difficulty seeing newsprint

A lot

Mental condition

Feeling sad, depressed or miserable

Often or always

 

Problems with everyday memory

Always

 

Difficulty managing finances

Always

 

Problems remembering medication

Often or always

Physical condition

Vomited blood

Yes1

 

Coughed up blood

Yes1

 

Severe shortness of breath sitting

Yes

 

Severe swollen legs

Yes

 

Unexpected weight loss

Yes1

 

Falls in last six months

> 41

Incontinence

Urinary

Once a week or more often

 

Faecal

Once a week or more often

Use of medicines

Number of prescribed medicines

> 7

Mobility

Walk 50 yards

Unable and no help

 

Go up and down stairs and steps

Unable and no help

 

Do shopping

Unable and no help

Lifestyle (not part of GP contract)

Use of alcohol in previous week Current smoker (amount daily) Physical activity

Not included as trigger

For nurse/lay only

 

Any other condition/problem warranting a detailed assessment

  1. 1 Potentially serious symptom triggering detailed assessment