Adaptation of the comprehensive geriatric assessment to a virtual delivery format

Loewenthal, Julia; DuMontier, Clark; Cooper, Lisa; Frain, Laura; Waldman, Louis S; Streiter, Shoshana; Cardin, Kristin; Tulebaev, Samir; Javedan, Houman; Orkaby, Ariela R.; Hshieh, Tammy T.

doi:10.1093/ageing/afaa257

Cited by 8 publications

(10 citation statements)

References 3 publications

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“…Moreover, in terms of preventive measures, vaccination coverage drastically reduced COVID-19 incidence, emergency department visits, and hospitalization rate among older adults [73,74], but it is only one piece of the puzzle for the "exit strategy" from the COVID-19 pandemic. Even in this context, the multidimensional approach could be helpful to explore more compromised domains of health status and design ad hoc interventions [72,75]. Reinforcement and promotion of healthy lifestyles (e.g.…”

Section: The Multidimensional Approach To Older Individuals During a ...mentioning

confidence: 99%

A multidimensional approach to older patients during COVID-19 pandemic: a position paper of the Special Interest Group on Comprehensive Geriatric Assessment of the European Geriatric Medicine Society (EuGMS)

et al. 2023

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Purpose The COVID-19 pandemic has been a dramatic trigger that has challenged the intrinsic capacity of older adults and of society. Due to the consequences for the older population worldwide, the Special Interest Group on Comprehensive Geriatric Assessment (CGA) of the European Geriatric Medicine Society (EuGMS) took the initiative of collecting evidence on the usefulness of the CGA-based multidimensional approach to older people during the COVID-19 pandemic. Methods A narrative review of the most relevant articles published between January 2020 and November 2022 that focused on the multidimensional assessment of older adults during the COVID-19 pandemic. Results Current evidence supports the critical role of the multidimensional approach to identify older adults hospitalized with COVID-19 at higher risk of longer hospitalization, functional decline, and short-term mortality. This approach appears to also be pivotal for the adequate stratification and management of the post-COVID condition as well as for the adoption of preventive measures (e.g., vaccinations, healthy lifestyle) among non-infected individuals. Conclusion Collecting information on multiple health domains (e.g., functional, cognitive, nutritional, social status, mobility, comorbidities, and polypharmacy) provides a better understanding of the intrinsic capacities and resilience of older adults affected by SARS-CoV-2 infection. The EuGMS SIG on CGA endorses the adoption of the multidimensional approach to guide the clinical management of older adults during the COVID-19 pandemic.

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Section: The Multidimensional Approach To Older Individuals During a ...mentioning

confidence: 99%

A multidimensional approach to older patients during COVID-19 pandemic: a position paper of the Special Interest Group on Comprehensive Geriatric Assessment of the European Geriatric Medicine Society (EuGMS)

et al. 2023

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“…107,108 Multidimensional tools have been validated using telemedicine. 109,110 Some gadgets transfer health information (vital signs, falls, body weight) directly from patients to web platforms. Although much still remains to be done regarding digital inclusion, remote medical appointments have succeeded in collecting comprehensive information from older patients.…”

Section: Barriers and Future Perspectivesmentioning

confidence: 99%

“…This model has also been used to follow patients after an in-person visit, helping improve adherence, connect health professionals with the patients' home environments, and adjust care plans according to the achieved results. 110…”

Section: Barriers and Future Perspectivesmentioning

confidence: 99%

Delivering patient-centered care: outcomes of comprehensive geriatric assessment across healthcare settings

Roma

Garção²,

Covinsky³

et al. 2022

Geriatr Gerontol Aging

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Comprehensive geriatric assessment (CGA) is a systematic multidimensional and interdisciplinary evaluation that enables clinicians to recognize age-related impairments and develop a coordinated treatment plan and follow-up suited to the patient's needs. Considering the growing number of older persons requiring care in health systems everywhere and the importance of shifting from a disease-specific care model to a more comprehensive care model, we aimed to present the benefits of CGA for older people in different healthcare settings using a narrative review. This patient-centered model of care has been associated with lower hospital (re)admission, maintenance of function, improved quality of life, less caregiver burden, and higher patient satisfaction with the care provided across different healthcare settings. In some contexts — for example, hospitalized older people —, CGA has already been established as the standard model of care as it was consistently related to reduced mortality. Consistent findings from specific contexts (eg, oncology, orthopaedics) also show the importance of CGA in aiding clinicians make better decisions for older patients. It is noteworthy that further evidence from cost-effectiveness studies is still warranted, particularly in community settings. Another encouraging topic for future research is the role of technology in disseminating CGA-based models of care.

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“…Throughout the COVID‐19 pandemic, we have relied on telemedicine to continue delivering patient care to vulnerable older populations. The FI‐CGA was easily adapted to a telemedicine format without losing the comprehensive approach 30 . By using the FI‐CGA, our team was able to continue providing best geriatric assessment and care, with some minor changes in the assessment of certain geriatric domains.…”

Section: Areas Of Ongoing Process Improvementmentioning

confidence: 99%

From research to bedside: Incorporation of a CGA‐based frailty index among multiple comanagement services

Cooper

Loewenthal

Frain

et al. 2021

J American Geriatrics Society

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The comprehensive geriatric assessment (CGA) is the core tool used by geriatricians across diverse clinical settings to identify vulnerabilities and estimate physiologic reserve in older adults. In this paper, we demonstrate the iterative process at our institution to identify and develop a feasible, acceptable, and sustainable bedside CGA-based frailty index tool (FI-CGA) that not only quantifies and grades frailty but also provides a uniform way to efficiently communicate complex geriatric concepts such as reserve and vulnerability with other teams. We describe our incorporation of the FI-CGA into the electronic health record (EHR) and dissemination among clinical services. We demonstrate that an increasing number of patients have documented FI-CGA in their initial assessment from 2018 to 2020, while additional comanagement services were established (Figure 2). The acceptability and sustainability of the FI-CGA, and

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Adaptation of the comprehensive geriatric assessment to a virtual delivery format

Cited by 8 publications

References 3 publications

A multidimensional approach to older patients during COVID-19 pandemic: a position paper of the Special Interest Group on Comprehensive Geriatric Assessment of the European Geriatric Medicine Society (EuGMS)

A multidimensional approach to older patients during COVID-19 pandemic: a position paper of the Special Interest Group on Comprehensive Geriatric Assessment of the European Geriatric Medicine Society (EuGMS)

Delivering patient-centered care: outcomes of comprehensive geriatric assessment across healthcare settings

From research to bedside: Incorporation of a CGA‐based frailty index among multiple comanagement services

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