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

Geriatrics ◽  
2020 ◽  
Vol 5 (1) ◽  
pp. 5 ◽  
Author(s):  
Katarina Wilhelmson ◽  
Isabelle Andersson Hammar ◽  
Anna Ehrenberg ◽  
Johan Niklasson ◽  
Jeanette Eckerblad ◽  
...  
Keyword(s):  
Older People ◽  
Geriatric Assessment ◽  
Study Design ◽  
Comprehensive Geriatric Assessment ◽  
Controlled Study ◽  
Control Group ◽  
Frail Older People ◽  
Positive Effects ◽  
Health And Social Care ◽  
Randomised Controlled

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.

scholarly journals 17 Improving Frailty Identification and Comprehensive Geriatric Assessment (CGA) Completion on the Wards

2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i1-i8
Author(s):  
D Verma ◽  
F Bonora ◽  
R Walker ◽  
M Kaneshamoorthy ◽  
L Bafadhel
Keyword(s):  
Older People ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Elderly Care ◽  
Frail Older People ◽  
Clinical Frailty Scale ◽  
Improvement Project ◽  
Qualitative Feedback ◽  
Complicated Course ◽  
User Friendly

Abstract Introduction The Comprehensive Geriatric Assessment (CGA) is known to deliver substantial and measurable health improvements to frail older people, including increased independence and a reduction in mortality.1 The Clinical Frailty Scale (CFS) can detect older adults at higher risk of complicated course and longer hospital stay.2 Despite the known benefits, previous audits has shown poor documentation on geriatric wards at Southend Hospital. Therefore, we devised a Quality Improvement Project to improve the uptake of both these. Methods A total of two Plan Do Study Act (PDSA) cycles were completed where CGA completion and CFS documentation was audited. Each cycle lasted two weeks (25 patients). Qualitative feedback was obtained from the members of multidisciplinary team to aid improvements. The baseline audit was based on the introduction of a 2-page ward proforma for all new patients. The first intervention was an improved 2-page ward-proforma. The second intervention was a single page ward-proforma. Results Originally, 40% of new patients admitted onto the ward had a CGA assessment and CFS score. After the first intervention, 79% (19) patients had a CFS score and a CGA assessment. 21% had a full CGA completed and 58% had partial CGA. Feedback included wanting a single page proforma to increase uptake. Questions needed to be more unambiguous and more tick boxes. After the second intervention 100% (25) patients had a CFS score and a CGA assessment. 40% (10) had a full CGA completed and 60% (15) had a partial CGA. Feedback include incorporating the ward round documentation to avoid repetition. Conclusions The results show that by using a focused, concise and user-friendly proforma, uptake of the Comprehensive Geriatric Assessment and Clinical Frailty Scale can be significantly increased, bringing substantial and measurable health improvements to frail older people admitted to elderly care wards. References 1. Welsh TJ, Gordon AL, Gladman JR. Int J Clin Pract. 2014;68(3):290–293. 2. Juma S, Taabazuing MM, Montero-Odasso M. Can Geriatr J. 2016;19(2):34–39.

scholarly journals Comprehensive geriatric assessment of frail older people: ideals and reality

2018 ◽  
Vol 32 (6) ◽  
pp. 728-734 ◽  
Author(s):  
Synneve Dahlin Ivanoff ◽  
Anna Duner ◽  
Kajsa Eklund ◽  
Katarina Wilhelmson ◽  
Eva Lidén ◽  
...  
Keyword(s):  
Older People ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Frail Older People

scholarly journals Analgesia and patient comfort after enhanced recovery after surgery in uvulopalatopharyngoplasty: a randomised controlled pilot study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fei Huang ◽  
Minxue Wang ◽  
Huixin Chen ◽  
Nan Cheng ◽  
Yanling Wang ◽  
...  
Keyword(s):  
Pilot Study ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Patient Comfort ◽  
Controlled Study ◽  
Control Group ◽  
Care Hospital ◽  
Positive Effects ◽  
Obstructive Sleep ◽  
Randomised Controlled

Abstract Background Uvulopalatopharyngoplasty(UPPP) is the most prevalent surgical treatment of obstructive sleep apnea, but postoperative pharyngeal pain may affect patient comfort. The enhanced recovery after surgery pathway has been proved beneficial to many types of surgery but not to UPPP yet. The aim of this pilot study was to preliminarily standrize an enhanced recovery after surgery protocol for UPPP, to assess whether it has positive effects on reducing postoperative pharyngeal pain and improving patient comfort, and to test its feasibility for an international multicentre study. Methods This randomised controlled study analysed 116 patients with obstructive sleep apnoea (OSA) who were undergoing UPPP in a single tertiary care hospital. They were randomly divided according to treatment: the ERAS group (those who received ERAS treatment) and the control group (those who received traditional treatment). Ninety-five patients completed the assessment (ERAS group, 59 patients; control group, 36 patients). Pharyngeal pain and patient comfort were evaluated using a visual analogue scale (VAS) at 30 min and at 6, 12, 24 and 48 h after UPPP. Complications, hospitalisation duration, and hospital cost were recorded. Results The VAS scores for resting pain and swallowing pain were significantly lower in the ERAS group than those in the control group at 30 min and at 6, 12, 24 and 48 h after surgery. Patient comfort was improved in the ERAS group. The hospitalisation duration and cost were comparable between the groups. The incidence of complications showed an increasing trend in the ERAS group. Conclusion The ERAS protocol significantly relieved pharyngeal pain after UPPP and improved comfort in patients with OSA, which showed the prospect for an larger study. Meanwhile a potential increase of post-operative complications in the ERAS group should be noticed. Trial registration Chinese Clinical Trial Registry (23/09/2018, ChiCTR1800018537)

scholarly journals Is care based on comprehensive geriatric assessment with mobile teams better than usual care? A study protocol of a randomised controlled trial (The GerMoT study)

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e023969 ◽  
Author(s):  
Anne Wissendorff Ekdahl ◽  
Anna Axmon ◽  
Magnus Sandberg ◽  
Katarina Steen Carlsson
Keyword(s):  
Health Care ◽  
Older People ◽  
Usual Care ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Outpatient Care ◽  
Primary Outcome ◽  
Exclusion Criterion ◽  
Link Type ◽  
Randomised Controlled

IntroductionComprehensive geriatric assessment (CGA) is a multidimensional, interdisciplinary diagnostic process used to determine the medical, psychological and functional capabilities of frail older people. The primary aim of our current study is to confirm whether CGA-based outpatient care is superior than usual care in terms of health-related outcomes, resource use and costs.Methods and analysisThe Geriatric Mobile Team trial is designed as a single-centre randomised, controlled, assessor-blinded (at baseline) trial. All participants will be identified via local healthcare registries with the following inclusion criteria: age ≥75 years, ≥3 different diagnoses and ≥3 visits to the emergency care unit (with or without admittance to hospital) during the past 18 months. Nursing home residency will be an exclusion criterion. Baseline assessments will be done before the 1:1 randomisation. Participants in the intervention group will, after an initial CGA, have access to care given by a geriatric team in addition to usual care. The control group receives usual care only. The primary outcome is the total number of inpatient days during the follow-up period. Assessments of the outcomes: mortality, quality of life, health care use, physical functional level, frailty, dependence and cognition will be performed 12 and 24 months after inclusion. Both descriptive and analytical statistics will be used, in order to compare groups and for analyses of outcomes over time including changes therein. The primary outcome will be analysed using analysis of variance, including in-transformed values if needed to achieve normal distribution of the residuals.Ethics and disseminationEthical approval has been obtained and the results will be disseminated in national and international journals and to health care leaders and stakeholders. Protocol amendments will be published in ClinicalTrials.gov as amendments to the initial registrationNCT02923843. In case of success, the study will promote the implementation of CGA in outpatient care settings and thereby contribute to an improved care of older people with multimorbidity through dissemination of the results through scientific articles, information to politicians and to the public.Trial registration numberNCT02923843; Pre-results.

Older people and urgent care

2020 ◽  
pp. 539-547
Author(s):  
Simon Conroy ◽  
Jay Banerjee
Keyword(s):  
Older People ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Functional Decline ◽  
Urgent Care ◽  
Care Services ◽  
Global Issue ◽  
Health And Social Care ◽  
Traditional Paradigm ◽  
Multiple Morbidities

Older people, especially those with frailty, are increasingly becoming the main users of urgent care services, despite efforts to promote care at home. This is a global issue. Older people with frailty will usually present with non-specific presentations, multiple morbidities, functional decline, and differential challenge (those most in need are least able to access the services they require) a constellation that challenges the traditional paradigm of urgent care responses. Comprehensive geriatric assessment is a useful evidence-based, overarching framework to guide assessment and management of older people with frailty presenting with crises. Geriatric teams should be excellent at delivering comprehensive geriatric assessment, but all clinicians throughout the health and social care system need to be able to apply its principles.

Effects of a Multicomponent Exercise Program on Functional Ability in Community-Dwelling, Frail Older Adults

2001 ◽  
Vol 9 (4) ◽  
pp. 414-424 ◽  
Author(s):  
Charlotte H. Worm ◽  
Esther Vad ◽  
Lis Puggaard ◽  
Henrik Støvring ◽  
Jens Lauritsen ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Older People ◽  
Functional Ability ◽  
Intervention Group ◽  
Exercise Program ◽  
Voluntary Contraction ◽  
Community Dwelling ◽  
Controlled Study ◽  
Control Group ◽  
Frail Older People

The purpose of this study was to determine the effects of a multicomponent exercise program on basic daily functions and muscle strength in community-dwelling frail older people. The randomized, controlled study comprised 46 community-dwelling frail older people (above 74 years of age and not able to leave their home without mobility aids). For 12 weeks the intervention group (n = 22) was transported to 2 class-based exercise sessions each week. Assessment of physical function was obtained using Berg's Balance Scale and a walking test. Self-reported functional ability was assessed through SF-36. Maximal oxygen uptake and maximal voluntary contraction of the shoulders' abductors were measured. The intervention group had a significant improvement in balance, muscle strength, walking function, and self-assessed functional ability compared with the control group. This study demonstrates that multicomponent exercise has a significant effect on basic daily functions and muscle strength in community-dwelling frail older people and might improve their ability to live an independent life.

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