Selection of Suitable Patients for a Geriatric Assessment: a Guideline Feasibility Test
DOI: 10.3238/zfa.2016.0308-0313german translation / full article
Background: Evidence from secondary care shows that geriatric assessments reduce negative health outcomes. However, in primary care it remains unclear which patients benefit from this resource-intensive intervention and how to identify them. Two internationally validated short tests (FiND and SOF indices) were identified for possible inclusion in the primary care guideline “Geriatric Assessment”. This study aimed to test their feasibility and acceptance.
Methods: Cross-sectional study; over a period of one week, patients ? 70 ys. from family practices in Hesse were invited. After providing written informed consent, patients were asked to fill in a questionnaire in the waiting room (8 items – FiND & SOF) and to conduct a chair rise test during their consultation. Results were analysed descriptively and for agreement with respect to frailty and disability. Feasibility was further examined in group discussions with some of the participating family practitioners.
Results: N = 541 patients (age Ø77 ys, 54 % female) from 25 practices were included. Of these, 18 % were “frail” according to FiND vs. 23 % according to SOF. Best test agreement was for “robust” vs. “non-robust” (including disabled, frail, and pre-frail), with 30 % of patients classified as “robust”. For family practitioners, 24 % of test results were unexpected. During group discussions, practitioners considered the tests feasible, objective, time-saving, and superior to their own appraisal of vulnerability in patients.
Conclusions: Waiting room questionnaires on the FiND and SOF indices and the chair rise test were feasible and supported the objective identification of vulnerable patients suitable for geriatric assessment.