Involving Primary Care Health Professionals in Geriatric Assessment

Fougère, Bertrand; Cesari, Matteo; Arai, Hidenori; Woo, Jean; Merchant, Reshma Aziz; Flicker, Leon; Cherubini, Antonio; Bauer, Jüergen M.; Vellas, Bruno; Morley, John E.

doi:10.1007/s12603-018-1001-0

Cited by 3 publications

(5 citation statements)

References 40 publications

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“…As geriatric patients are prone to multiple health problems, they would benefit from integration of various services required, and there should be an emphasis on function rather than on single-disease treatment. 25,26 This would potentially reduce waiting times and improve the overall quality of geriatric healthcare. Training of health professionals should consider the need for a compassionate and comprehensive approach when seeing geriatric patients.…”

Section: Resultsmentioning

confidence: 99%

What the elderly experience and expect from primary care services in KwaZulu-Natal, South Africa

Naidoo

Wyk

2019

African Journal of Primary Health Care & Family Medicine

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BackgroundPeople aged 60 years and above are predicted to outnumber those aged under 5 years in South Africa for the first time by 2040. This will put increased demands on the health system to address geriatric health needs. However, data on geriatric populations in sub-Saharan Africa are scarce. Health policymakers need to be informed of the expectations of the elderly people regarding health services, especially at primary care level.AimThe aim of this study was to explore the experiences and expectations of people aged 60 years and above regarding ageing and health services, and the factors that might improve the quality of primary care services for geriatric patients.SettingThe study was conducted at three public health primary care facilities in KwaZulu-Natal province, South Africa: one in a rural setting, one in a peri-urban and one in an urban setting.MethodsThis qualitative study involved a purposive sample of 28 participants, aged 60 years and above. Four focus group discussions were conducted in either isiZulu or English, depending on the preference of the participants. Data were analysed thematically using an inductive approach.ResultsNineteen of the 28 participants were women. Five key findings emerged from the study: (1) long waiting times – participants were distressed by lengthy waiting times, (2) illness-centred care – participants felt that they were seen as diseases to be treated, (3) lack of caring – health providers were perceived to lack compassion, (4) pill burden – participants experienced adverse effects of prescribed medication and (5) need for priority care – participants wanted a separate queue for the elderly.ConclusionHealth systems and health professions educators should consider the need for patient-centred and integrated care for geriatric populations. Further research is required on the unmet needs of geriatric people in the community.

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Section: Resultsmentioning

confidence: 99%

What the elderly experience and expect from primary care services in KwaZulu-Natal, South Africa

Naidoo

Wyk

2019

African Journal of Primary Health Care & Family Medicine

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“…Primary care practices worldwide are often overwhelmed with multitudes of clinical issues ranging from neonates to frail older adults, and CGA is often not on their cards as it is time-consuming. Despite advances worldwide in developing practical tools in primary care, the overall take-up has been low due to multiple reasons including lack of skills, time, and reimbursement ( 9 , 16 ). In addition, in countries like Singapore where we have different ethnic groups, there's often a language barrier in conducting CGA.…”

Section: Discussionmentioning

confidence: 99%

“…There is no one effective strategy to implement CGA in primary care which is rapid and cost-effective and does not require geriatricians or geriatric trained nurse clinicians to perform the assessments ( 10 , 14 ). Many brief screening tools have been developed worldwide to be used in primary care including Gerontopôle Frailty Screening Tool (GFST) which includes a dedicated pathway for disability prevention, Kihon Checklist (KCL) which is a self-reported comprehensive health checklist, Vulnerable Elders Survey-13 (VES-13) which is a self-administered questionnaire with the aim of identifying those at risk of death or functional decline, Easycare Two-step Older persons Screening (Easycare-TOS) which is a brief standardized tool for assessing perceptions of older adults about their health and care needs, and the Electronic Frailty Index in the United Kingdom ( 11 , 15 , 16 ). Most assessment tools are predominantly screening or case finding tools with limited or no interventions recommended.…”

Section: Introductionmentioning

confidence: 99%

“…Rapid Geriatric Assessment (RGA) is one of the most practical tools developed at St. Louis University and takes <5 min to screen for frailty, sarcopenia, anorexia of aging (AA), and cognition and does not require a geriatrician to administer the assessment ( 1 , 16 ). RGA comprises of four screening tools including the FRAIL scale for frailty, the SARC-F scale for sarcopenia, the Simplified Nutritional Appetite Questionnaire (SNAQ) for AA, and the Rapid Cognitive Screen (RCS) for cognition ( 17 ) ( Supplementary 1 ).…”

Section: Introductionmentioning

confidence: 99%

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Rapid Geriatric Assessment Using Mobile App in Primary Care: Prevalence of Geriatric Syndromes and Review of Its Feasibility

et al. 2020

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With the aging population and consequent increase in associated prevalence of frailty, dementia, and multimorbidity, primary care physicians will be overwhelmed with the complexity of the psychosocial and clinical presentation. Geriatric syndromes including frailty, sarcopenia, cognitive impairment, and anorexia of aging (AA) either in isolation or in combination are associated with an increased risk of adverse outcomes and if recognized early, and appropriately managed, will lead to decreased disability. Primary care practices are often located in residential settings and are in an ideal position to incorporate preventive screening and geriatric assessment with personalized management. However, primary care physicians lack the time, multidisciplinary resources, or skills to conduct geriatric assessment, and the limited number of geriatricians worldwide further complicates the matter. There is no one effective strategy to implement geriatric assessment in primary care which is rapid, cost-effective, and do not require geriatricians. Rapid Geriatric Assessment (RGA) takes <5 min to complete. It screens for frailty, sarcopenia, AA, and cognition with assisted management pathway without the need of a geriatrician. We developed RGA iPad application for screening with assisted management in two primary care practices and explored the feasibility and overall prevalence of frailty, sarcopenia, and AA. The assessment was conducted by trained nurses and coordinators. Among 2,589 older patients ≥65 years old, the prevalence of frailty was 5.9%, pre-frail 31.2%, and robust 62.9%. Fatigue was present in 17.8%, and among them, the prevalence of undiagnosed depression as assessed by the Patient Health Questionnaire (PHQ)-9 was 76.4% and 13.5% of total. The prevalence of sarcopenia was 15.4%, and 13.9% experienced at least one fall in the past year. AA was prevalent in 10.9%. The time taken to do the assessment with defined algorithm was on average 5 min or less per patient, and 96% managed to complete the assessment prior to seeing their doctor in the same session. The RGA app is a rapid and feasible tool to be used by any healthcare professional in primary care for identification of geriatric syndrome with assisted management.

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“…Primary care is often the foundation of healthcare system in many countries, has major impact on population health, and is a core site for preventive health screening (3). Because of the limited time available in primary care practice, a number of screening tests have been developed to allow the recognition of the presence of these syndromes (4).…”

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confidence: 99%