AMPI-AB validity and reliability: a multidimensional tool in resource-limited primary care settings

Abstract

Background: The early identification of individuals at high risk for adverse outcomes by a Comprehensive Geriatric Assessment (CGA) in resource-limited primary care settings enables tailored treatments, however, the evidence concerning its benefits are still controversial. The main objective of this study was to examine the validity and reliability of the "Multidimensional Assessment of Older People in Primary Care (AMPI-AB)", a CGA for primary care in resource-limited settings. Methods: Longitudinal study, with median follow-up time of 16 months. Older adults from a public primary care unit in São Paulo, Brazil, were consecutively admitted. Reliability was tested in a sample from a public geriatric outpatient clinic. Participants were classified by the AMPI-AB score as requiring a low, intermediate or high complexity of care. The Physical Frailty Phenotype was used to explore the AMPI-AB's concurrent validity. Predictive validity was assessed with mortality, worsening of the functional status, hospitalizations, emergency room (ER) visits and falls. The area under the ROC curve and logistic regression were calculated for binary outcomes, and a Cox proportional hazards model was used for survival analysis.(Continued on next page)

Instrumentos Aplicados Na Atenção Primária Para Identificação Da Síndrome De Fragilidade Em Pessoas Idosas: Revisão Integrativa

“…Considerando os componentes do fenótipo de fragilidade proposto por Fried et al (2001), quanto a comportamento sedentário, fraqueza e diminuição da marcha (2001) também é utilizado para subsidiar a validade de outras propostas de assistência à saúde para pessoas idosas na condição de fragilidade, a exemplificar a AMPI-AB, desenvolvida por especialistas em geriatria, gerontologia e saúde pública da Secretaria Municipal de Saúde de São Paulo (SÃO PAULO, 2021). O instrumento está em processo de validação, e estudos preliminares demostraram boa acurácia e confiabilidade na gestão de saúde de idosos (ANDRADE et al, 2020;SARAIVA et al, 2020).…”

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

“…Some quick and easy-to-use CGA-based tools have been validated to facilitate the use of geriatric measures in practice. 3,12,94 These tools are less time-consuming and do not require skilled resources, which are challenging to obtain in most clinical settings. For example, the 10-TaGA offers information on ten health domains using a practical method that combines self-reported items and performance tests.…”

“…7 Previous studies have demonstrated the importance of comprehensive geriatric assessment (CGA) in guiding the care of older people. [10][11][12][13] It complements the conventional medical approach by integrating information on social, physical, cognitive, and psychological aspects related to function and interferes progressively with health and quality of life as people age. 3,14 CGA was conceived by Dr. Marjory Warren during a successful interdisciplinary rehabilitation initiative offered to in-hospital patients with disabilities in London during the first half of the 20th century.…”

Capacidade funcional e práticas de autocuidado de idosos: norteadores para atenção integral a idosos a partir da atenção primária à saúde

“…Recentemente foi publicado artigo examinando a validade e a confiabilidade do instrumento AMPI-AB, onde a mesma foi considerada instrumento válido e confiável para avaliar idosos em ambiente de atenção primária com recursos escassos. Sendo precisa na detecção de fragilidade física e prévia de mortalidade, agravo de incapacidades, hospitalizações, consultas de emergência e quedas entre os idosos na atenção primária (Saraiva et al, 2020). Trata-se do primeiro estudo que avalia um instrumento para gerenciar cuidados de saúde de idosos em um sistema de saúde pública em países de média-baixa renda, foi desenvolvido por um conjunto de especialistas em saúde pública, geriatria e gerontologia.…”