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How’s Your Health at Home: Frail Homebound Patients Reported Health Experience and Outcomes*

  • Margaret J. McGregor (a1) (a2) (a3), Jay Slater (a2), John Sloan (a2), Kimberlyn M. McGrail (a1) (a3) (a4), Anne Martin-Matthews (a5), Shannon Berg (a1) (a6), Alyson Plecash (a2), Leila Sloss (a2), Johanna Trimble (a2) (a7) and Janice M. Murphy (a8)...


We used a web-based mixed methods survey (HowsYourHealth – Frail) to explore the health of frail older (78% age 80 or older) adults enrolled in a home-based primary care program in Vancouver, Canada. Sixty per cent of eligible respondents participated, representing over one quarter (92/350, 26.2%) of all individuals receiving the service. Despite high levels of co-morbidity and functional dependence, 50 per cent rated their health as good, very good, or excellent. Adjusted odds ratios for positive self-rated health were 7.50, 95 per cent CI [1.09, 51.81] and 4.85, 95 per cent CI [1.02, 22.95] for absence of bothersome symptoms and being able to talk to family or friends respectively. Narrative responses to questions about end of life and living with illness are also described. Results suggest that greater focus on symptom management, and supporting social contact, may improve frail seniors’ health.

Pour notre sondage, nous avons utilisé une méthodologie mixte basée sur le Web (How’s Your Health – Frail) pour examiner la santé des adultes fragiles (78% âgés de 80 ans et plus) inscrits à un programme de soins primaires à domicile à Vancouver, au Canada. Soixante pour cent des répondants admissibles ont participé, représentant plus d’un quart (92/350, 26,2%) de tous les individus qui reçoivent le service. Malgré des niveaux élevés de co-morbidité et de dépendance fonctionnelle, 50% ont jugé leur santé aussi bonne, très bonne ou excellente. Les ratios de cotes ajustés pour l’auto-évaluation de sa santé positive étaient de 7,50, 95 pour cent d’intervalle de confiance (IC) [1,09, 51,81] et 4,85, 95% CI [1,02, 22,95] pour l’absence de symptômes gênants et le pouvoir de parler à la famille ou amis, respectivement. Des réponses narratives aux questions sur la fin de vie et la vie avec une maladie sont également décrites. Les résultats suggèrent que l’accent mis sur la gestion des symptômes, et le soutien des contacts sociaux, peut améliorer la santé des personnes âgées fragiles.

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This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (, which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

Correspondence and requests for reprints should be sent to / La correspondance et les demandes de tirés-à-part doivent être adresées à : Margaret J. McGregor, M.D., M.H.Sc. Department of Family Practice University of British Columbia Room 713, 828 West 10th Avenue Vancouver, BC V5Z 1L8 (


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We gratefully acknowledge the following individuals: John H. Wasson (creator of HowsYourHealth survey tool, Emeritus Professor of Community and Family Medicine and Medicine, Dartmouth Medical School); Megan Luk and Asheya Kushner (research assistants) who administered the HowsYourHealth – Frail survey; Michelle Cox (research analyst, UBC Dept. of Family Practice Community Geriatrics) and Lisa Ronald (Vancouver Coastal Health Research Institute Centre for Clinical Epidemiology & Evaluation) who assisted in data analysis; and the librarians of the BC College of Physicians and Surgeons Library who assisted with literature searches.

This study (2013–2014) was supported by a grant from the British Columbia College of Family Physicians and the Department of Family Practice Community Geriatrics.



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Canadian Journal on Aging / La Revue canadienne du vieillissement
  • ISSN: 0714-9808
  • EISSN: 1710-1107
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