A pilot study to assess attitudes, behaviors, and inter-office communication by psychiatrists and primary care providers in the care of older adults with schizophrenia.

INTRODUCTION: There is a lack of assessment tools and empirical data concerning clinician attitudes and behaviors with respect to the health care of older adults with schizophrenia. We develop a survey instrument of physician attitudes, behavior, and inter-office communication, and provide preliminary data on physician-related issues in the provision of health care to this population.

METHODS: A semi-structured 20-item survey instrument was administered to a stratified convenience sample of 24 primary care physicians (PCPs) and 27 psychiatrists working in the New York metropolitan area. Using open ended and multiple choice items, scales, summed scores, and case vignettes, we assessed attitudes, experiences, and procedures in treating medical illnesses in older persons with schizophrenia. All scales had internal consistency reliabilities of >0.70.

RESULTS: There were no differences between PCPs and psychiatrists in reported and anticipated behavior towards older adults with symptoms of schizophrenia, and both groups displayed favorable views. However, both groups had slightly negative stereotypes and attitudes concerning these patients. PCPs reported receiving information from psychiatrists slightly more than 0 to 10 percent of the time.

CONCLUSIONS: Our preliminary findings indicated more favorable attitudes and behaviors by PCPs than had been anticipated based on earlier research with younger patients. The data suggest that the failure of older schizophrenia patients to receive adequate treatment may not be due primarily to clinicians' negative attitudes and behaviors, and that problems with communication may play a more important role.