69 What Health Outcomes Matter to Frail Older People?

2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i21-i21
Author(s):  
K S Tipping

Abstract Introduction The purpose of this project was to explore what health outcomes matter to frail older people. This would provide information that would be of use to both providers and payers of health care services to align their priorities in line with these. Frailty is an important and relevant topic in healthcare. In England 5% of people aged 60-69 have frailty. This rises to 65% in people aged over 90. There are 1.8 million people aged over 60 and 0.8 million people aged over 80 living with frailty. (English Longitudinal Study of Ageing (2016)). This number is due to increase. The aims of this research were: To review the literature on health outcomes in older people including frail older people.To conduct a focus group interview with frail older people to ascertain their views on health outcomes.To disseminate and share the reviews and study findings via presentations and publications. Ethics Ethical approval was granted by the University of Liverpool’s Health and Life Sciences Research Ethics Committee (application number 4163). Methods A systematic review of the literature was undertaken. Thereafter a focus group interview was held with six frail older people. The participants were aged 65 years and over and had mild to moderate frailty using the Clinical Frailty Scale. The interview recording was transcribed, and common themes identified and analysed. Results Eight themes were identified from the focus group: - Trust in medical professionalsVulnerability of being an older person in hospitalPolypharmacy and wastage of medicationDischarge Planning & Co-Ordination of Care at HomeTaking responsibility for your own healthNomenclatureAutonomyFalls Conclusion This study has identified themes that can be utilised to raise awareness among health care professionals on what matters to frail older people. The study findings will hopefully provide an opportunity for meaningful discussions around what is needed to better meet these desired health outcomes. References 1. Akpan A, Roberts C, Bandeen-Roche K, Batty B, Bausewein C, Bell D, et al. Standard set of health outcome measures for older persons. BMC Geriatr 2018;18(1):36. 2. Naik AD, Dindo LN, Van Liew JR, Hundt NE, Vo L, Hernandez-Bigos K, et al. Development of a Clinically Feasible Process for Identifying Individual Health Priorities. Journal of the American Geriatrics Society 2018;66(10):1872–9.

2020 ◽  
Author(s):  
Kathryn Tipping(Former Corresponding Author) ◽  
Asangaedem Akpan New

Abstract Background The study set out to interview older people with frailty and find out what healthcare issues matter to them. Older people with frailty are an important population subgroup. In the United Kingdom, over 65s already outnumber under 16s, and this is expected to increase. Research into health issues has been undertaken by the International Consortium for Health Outcomes Measurement (ICHOM) and this study builds on that. Recent research has been undertaken in America into health issues. However, these studies were not specifically focused on older people. Methods A scoping review of the literature was undertaken to highlight any gaps in this area of research. Thereafter a focus group interview was carried out with six older people with frailty. Qualitative research often uses smaller samples than quantitative research 7 . Braun and Clarke recommend that for a small project, such as this one, 6-10 interviews should be held. Braun and Clarke state that smaller groups (three to eight participants) work best in terms of generating a rich discussion and have the added benefit of being easier to manage 7 . The six participants were aged 65 years and over and had mild to moderate frailty using the Rockwood Clinical Frailty Scale. 8 The interview was recorded and transcribed, analysed and themes identified. Results The eight themes identified were trust in medical professionals, vulnerability of being an older person in hospital, polypharmacy and wastage of medication, discharge planning and co-ordination of care at home, taking responsibility for your own health, nomenclature, autonomy and falls. Conclusion This study has identified themes to raise awareness among health care professionals about what health issues matter to older people with frailty. The study findings will provide an opportunity for meaningful discussions around what is needed to meet these preferred health issues.


10.2196/17504 ◽  
2020 ◽  
Vol 22 (8) ◽  
pp. e17504 ◽  
Author(s):  
Katarina Eeg-Olofsson ◽  
Unn-Britt Johansson ◽  
Ebba Linder ◽  
Janeth Leksell

Background In effective diabetes management, it is important that providers and health care systems prioritize the delivery of patient-centered care and that they are respectful of and responsive to individual patient preferences and barriers. Objective The objective of the study was to conduct focus group interviews to capture patients’ and health care professionals’ perceptions and attitudes regarding digital technology and to explore how the digital Diabetes Questionnaire can be used to support patient participation in diabetes care, as a basis for an implementation study. Methods A qualitative study was conducted with six focus group discussions with diabetes specialist nurses and medical doctors (n=29) and four focus group discussions with individuals with diabetes (n=23). A semistructured focus group interview guide was developed, including probing questions. The data were transcribed verbatim, and qualitative content analysis was performed using an inductive approach. Results Two main categories were revealed by the qualitative analysis: perceptions of digital technology and the digital questionnaire in diabetes management and care and perceptions of participation in diabetes care. An overarching theme that emerged from the focus group interviews was patients’ and professionals’ involvement in diabetes care using digital tools. Conclusions The analysis identified important factors to consider when introducing the digital Diabetes Questionnaire in clinical use. Both professionals and patients need support and training in the practical implementation of the digital questionnaire, as well as the opportunity to provide feedback on the questionnaire answers.


2019 ◽  
Author(s):  
Katarina Eeg-Olofsson ◽  
Unn-Britt Johansson ◽  
Ebba Linder ◽  
Janeth Leksell

BACKGROUND In effective diabetes management, it is important that providers and health care systems prioritize the delivery of patient-centered care and that they are respectful of and responsive to individual patient preferences and barriers. OBJECTIVE The objective of the study was to conduct focus group interviews to capture patients’ and health care professionals’ perceptions and attitudes regarding digital technology and to explore how the digital Diabetes Questionnaire can be used to support patient participation in diabetes care, as a basis for an implementation study. METHODS A qualitative study was conducted with six focus group discussions with diabetes specialist nurses and medical doctors (n=29) and four focus group discussions with individuals with diabetes (n=23). A semistructured focus group interview guide was developed, including probing questions. The data were transcribed verbatim, and qualitative content analysis was performed using an inductive approach. RESULTS Two main categories were revealed by the qualitative analysis: <i>perceptions of digital technology and the digital questionnaire in diabetes management and care</i> and <i>perceptions of participation in diabetes care</i>. An overarching theme that emerged from the focus group interviews was <i>patients’ and professionals’ involvement in diabetes care using digital tools.</i> CONCLUSIONS The analysis identified important factors to consider when introducing the digital Diabetes Questionnaire in clinical use. Both professionals and patients need support and training in the practical implementation of the digital questionnaire, as well as the opportunity to provide feedback on the questionnaire answers.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bach Van Ho ◽  
Claar Debora van der Maarel-Wierink ◽  
Annemiek Rollman ◽  
Roxane Anthea Francesca Weijenberg ◽  
Frank Lobbezoo

Abstract Background Older people are encouraged to remain community dwelling, even when they become care-dependent. Not every dental practice is prepared or able to provide care to community-dwelling frail older people, while their ability to maintain oral health and to visit a dentist is decreasing, amongst others due to multiple chronic diseases and/or mobility problems. The public oral health project ‘Don’t forget the mouth! (DFTM!) aimed to improve the oral health of this population, by means of early recognition of decreased oral health as well as by establishing interprofessional care. A process evaluation was designed to scientifically evaluate the implementation of this project. Methods The project was implemented in 14 towns in The Netherlands. In each town, health care professionals from a general practice, a dental practice, and a homecare organization participated. The process evaluation framework focused on fidelity, dose, adaptation, and reach. Each of the items were examined on levels of implementation: macro-level, meso-level, and micro-level. Mixed methods (i.e., quantitative and qualitative methods) were used for data collection. Results The experiences of 50 health care professionals were evaluated with questionnaires, 22 semi-structured interviews were conducted, and the oral health of 407 community-dwelling frail older people was assessed. On each level of implementation, oral health care was integrated in the daily routine. On macro-level, education was planned (dose, adaption), and dental practices organized home visits (adaption). On meso-level, health care professionals attended meetings of the project (fidelity), worked interprofessionally, and used a screening-referral tool of the project DFTM! in daily practice (dose, adaption, reach). On micro-level, the frail older people participated in the screening of oral health (fidelity, dose), had their daily oral hygiene care observed (adaption) and supported if necessary, and some had themselves referred to a dental practice (reach). The semi-structured interviews also showed that the project increased the oral health awareness amongst health care professionals. Conclusions The project DFTM! was, in general, implemented and delivered as planned. Factors that contributed positively to the implementation were identified. With large-scale implementation, attention is needed regarding the poor accessibility of the oral health care professional, financial issues, and increased work pressure. Trial registration The Netherlands Trial Register NTR6159, registration done on December 13th 2016. URL: https://www.trialregister.nl/trial/6028


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