Comprehensive Geriatric Assessment for Frail Older People in Swedish Acute Care Settings (CGA-Swed): A Randomised Controlled Study

Abstract

The aim of the study is to evaluate the effects of the Comprehensive Geriatric Assessment (CGA) for frail older people in Swedish acute hospital settings – the CGA-Swed study. In this study protocol, we present the study design, the intervention and the outcome measures as well as the baseline characteristics of the study participants. The study is a randomised controlled trial with an intervention group receiving the CGA and a control group receiving medical assessment without the CGA. Follow-ups were conducted after 1, 6 and 12 months, with dependence in activities of daily living (ADL) as the primary outcome measure. The study group consisted of frail older people (75 years and older) in need of acute medical hospital care. The study design, randomisation and process evaluation carried out were intended to ensure the quality of the study. Baseline data show that the randomisation was successful and that the sample included frail older people with high dependence in ADL and with a high comorbidity. The CGA contributed to early recognition of frail older people’s needs and ensured a care plan and follow-up. This study is expected to show positive effects on frail older people’s dependence in ADL, life satisfaction and satisfaction with health and social care.

Research as an essentiality beyond one’s own competence: an interview study on frail older people's view of research

“…Involvement of frail older people in research could be a tool for a deeper understanding of the resources and needs of the ageing population, which, in turn, could be used to improve the quality of health and social care [ 13 ]. However, there is a lack of knowledge and theoretical support for when and how to involve frail older people in research.…”

Can Comprehensive Geriatric Assessment Meet Frail Older People’s Needs? Results from the Randomized Controlled Study CGA-Swed

“…Exclusion criteria were being admitted via a fast track (for stroke, coronary infarct, or a hip fracture). For more information and details about the study, see the pilot and study protocol [ 29 , 30 ].…”

“…The participants who were randomized to the intervention group received CGA on a geriatric acute medical ward. Assessments were both comprehensive and person-centered and were provided by a multidisciplinary team to address the frail older people’s multiple needs related to physical health, functional ability, psychological state, cognition, and social-environmental circumstances [ 15 , 30 , 32 ]. The CGA team consisted of geriatrically-trained medical doctors, nurses, nurse assistants, occupational therapists (OTs), and physical therapists (PTs).…”

“…The acute medical problem and symptoms of the patient determined the assessments and care provided on the control wards. The control ward did not work according to the comprehensive and person-centered approach included in a CGA [ 30 ].…”

New Variations on the Theme of Multidimensional Geriatric Assessment

“…Implemented or anticipated assessment-based models of “co-care” with other specialties, allied health providers, or for special clinical populations, are the subject of several reports [ 7 , 8 , 9 , 10 ]. One offering describes a protocol for a new experimental trial of comprehensive geriatric assessment in an acute care unit [ 11 ]; as person-centeredness is a common fundamental concern of clinicians and teams performing such assessments, it is fitting to have a second qualitative study on this topic from the same group [ 12 ]. Attention to common geriatric syndromes (e.g., falls) and assessment in developing countries and in multicultural immigrant populations is demonstrated in two other reports [ 13 , 14 ].…”