Does geriatric evaluation and management improve the health behavior of older veterans in psychological distress?

A randomized, controlled trial compared prospective 16-month health service use among 160 frail, elderly veterans receiving outpatient geriatric evaluation and management (GEM) or usual primary care (UPC). In this secondary analysis, multivariable regression was used to determine if the psychosocial assessment and support provided by the GEM team moderated the use of medical services by patients in psychological distress. The results indicate that GEM reduced outpatient use among patients who scored higher on a measure of somatization (p less than or equal to .05), but GEM increased outpatient use among patients with higher manifest anxiety (p less than or equal to .05) Psychological distress was not a factor in the use of inpatient services. GEM had a modest beneficial effect on the health behavior of frail older persons manifesting some symptoms of psychological distress.