Framework Implementation of the INSPIRE ICOPE-CARE program in collaboration with the World Health Organization (WHO) in the Occitania region

Abstract

Introduction: Limiting the number of dependent older people in coming years will be a major economic and human challenge. In response, the World Health Organization (WHO) has developed the «Integrated Care for Older People (ICOPE)» approach. The aim of the ICOPE program is to enable as many people as possible to age in good health. To reach this objective, the WHO proposes to follow the trajectory of an individual’s intrinsic capacity, which is the composite of all their physical and mental capacities and comprised of multiple domains including mobility, cognition, vitality / nutrition, psychological state, vision, hearing. Objective: The main objective of the INSPIRE ICOPE-CARE program is to implement, in clinical practice at a large scale, the WHO ICOPE program in the Occitania region, in France, to promote healthy aging and maintain the autonomy of seniors using digital medicine. Method: The target population is independent seniors aged 60 years and over. To follow this population, the 6 domains of intrinsic capacity are systematically monitored with pre-established tools proposed by WHO especially STEP 1 which has been adapted in digital form to make remote and large-scale monitoring possible. Two tools were developed: the ICOPE MONITOR, an application, and the BOTFRAIL, a conversational robot. Both are connected to the Gerontopole frailty database. STEP 1 is performed every 4-6 months by professionals or seniors themselves. If a deterioration in one or more domains of intrinsic capacity is identified, an alert is generated by an algorithm which allows health professionals to quickly intervene. The operational implementation of the INSPIRE ICOPE-CARE program in Occitania is done by the network of Territorial Teams of Aging and Prevention of Dependency (ETVPD) which have more than 2,200 members composed of professionals in the medical, medico-social and social sectors. Targeted actions have started to deploy the use of STEP 1 by healthcare professionals (physicians, nurses, pharmacists,…) or different institutions like French National old age insurance fund (CNAV), complementary pension funds (CEDIP), Departmental Council of Haute Garonne, etc. Perspective: The INSPIRE ICOPE-CARE program draws significantly on numeric tools, e-health and digital medicine to facilitate communication and coordination between professionals and seniors. It seeks to screen and monitor 200,000 older people in Occitania region within 3 to 5 years and promote preventive actions. The French Presidential Plan Grand Age aims to largely implement the WHO ICOPE program in France following the experience of the INSPIRE ICOPE-CARE program in Occitania.

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“…The pandemic crisis was also an accelerator for the launch of the INSPIRE ICOPE Care cohort (9) and ICOPE Monitor (10) to maintain function in older adults and prevent dependency. The INSPIRE ICOPE Care cohort aims to test the implementation of the ICOPE Program (11) in primary care in Occitanie Region using the ICOPE screening tool tailored to the needs of the study (ICOPE Monitor) and to monitor intrinsic capacity every 4 months.…”

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“…3) In France, the ICOPE pilot program (the INSPIRE ICOPE-CARE program) was implemented in clinical practice in the Occitania region to promote healthy aging and maintain the autonomy of seniors based on the use of digital medicine. 7) The target population is independent seniors aged 60 years and over. The six domains of IC are systematically monitored using pre-established tools proposed by the WHO, which have been adopted in digital form to allow remote and large-scale monitoring.…”

“…The French Presidential Plan Grand Age has largely implemented the WHO ICOPE program in France based on the experiences of the INSPIRE ICOPE-CARE program in Occitania. 7) Step 2 (person-centered assessment) and Step 3 (personalized care plan) of the INSPIRE ICOPE-CARE program are conducted by a general practitioner or if possible by a nurse trained in geriatrics. Experienced trained nurses of the Gerontopole perform geriatric evaluations of older people in their homes or public spaces close to their homes.…”

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“…The global aim is to prevent frailty for the robust and to prevent dependency for the frail (10). ICOPE Monitor (11)(12)(13) gives us the opportunity to monitor intrinsic capacities remotely and to intervene earlier. Alzheimer blood biomarkers (eg.…”