Care plan use among older people with functional impairment: analysis of the English General Practice Patient Survey

Objectives: Care plans may improve health when patients are involved in the care planning process. They are recommended for primary care. This study aimed to identify characteristics of older patients with functional impairment (age ≥75 years with problems completing daily activities) who report having a care plan and who are involved in care planning.

Methods: The General Practice Patient Survey (individual-level dataset) 2015-16 in England was analysed. Logistic regression was used to estimate associations between having a care plan and being involved with care planning and age, gender, ethnicity, deprivation, multimorbidity, interpersonal relationship with general practitioner (GP) and other variables, clustered at practice level.

Results: Three point five percent of GPPS respondents and 14.4% of older people with functional impairment reported having a care plan; however, only a quarter of the latter were involved with the care planning process. Involvement with care planning was associated with seeing own GP (odds ratio (OR) 1.88, 95% confidence interval (CI)1.48 to 2.38) and factors reflecting a positive interpersonal relationship with the GP, including having confidence in the GP (OR 5.92, CI 2.38 to 14.77). Respondents involved with care planning reported greater confidence in managing their own health.
Conclusions: Few older people with functional impairment report having a care plan and fewer report involvement in the care planning process. This may reduce the ability of care plans to deliver health benefits and person-centered care.