Fifth METRIC Module Covers Geriatric Care

The Academy has added a fifth item to its menu of modules in a performance improvement program known as METRIC, or Measuring, Evaluating and Translating Research Into Care.

Although the first four METRIC modules focused on clinical conditions, such as diabetes, coronary artery disease, asthma and chronic obstructive pulmonary disease, developers of this latest module -- Geriatrics: Improving Patient Care -- took a different approach by focusing the content on preventive medicine for a particular patient population.

"Geriatrics is going to be an increasing focus of our members because of the changes in the demographics of our population," said Bruce Bagley, M.D., AAFP's medical director of quality improvement.

According to a 2006 news release from the U.S. Census Bureau, the population of individuals age 65 and older is expected to double during the next 25 years. By 2030, nearly 20 percent of Americans -- about 72 million people -- will fall within that age group. In addition, the release noted that the 85-and-older age group is the fastest growing segment of the U.S. population.

The new METRIC module guides physicians through a list of chart review questions that cover such topics as a review of medications, an assessment of patients' risk for falls, the creation of an advance care plan, the presence of urinary incontinence in female patients and the administration of influenza vaccine.

Bagley said medication review and medication reconciliation is particularly important with geriatric patients. "Not only are seniors on lots of medications, but there is a much larger use of generics these days," he said. It's hard for the physician and the patient to keep track of a particular prescription drug "when it might not be the same color or even have the same name from one month to the next," he added.

Bagley noted that elderly patients should bring all of their medications with them every time they visit their physicians. "Going through which (medications) they're taking is really important," he said.

Physicians who reviewed and assessed the module before it was released praised it for its usability, appropriate content, and pertinent tools and resource links.

Reviewer David Walsworth, M.D., of East Lansing, Mich., a member of the AAFP Commission on Continuing Professional Development, said, "Geriatrics is an area that we all face in greater volume. I am a family doc who does not do nursing homes, but most of my patients are geriatric." He said some of the module content was applicable to not only his senior patients but to his general patient population, as well.

METRIC, which launched in 2005, was designed as a performance improvement initiative that could link evidence-based medicine with education, thereby giving physicians an opportunity to evaluate their management of chronic diseases while measuring and working to improve patient outcomes.

Physicians who complete a METRIC module fulfill the requirement for Part IV -- the performance-in-practice module -- of the American Board of Family Medicine's Maintenance of Certification Program for Family Physicians. Family medicine residency programs are using METRIC to fulfill Accreditation Council for Graduate Medical Education requirements for quality improvement projects.

The METRIC geriatrics module is supported by an educational grant to the AAFP from the AAFP Foundation and made possible by the Atlantic Philanthropies Foundation.