TY - JOUR
T1 - How can we improve Comprehensive Geriatric Assessment for older people living with frailty in primary care and community settings? A qualitative study
AU - the DREAM Study Team
AU - Mahmoud, Aseel
AU - Goodwin, Victoria A.
AU - Morley, Naomi
AU - Whitney, Julie
AU - Lamb, Sarah E.
AU - Lyndon, Helen
AU - Creanor, Siobhan
AU - Frost, Julia
AU - Clegg, Andrew
AU - Crocker, Tom
AU - Del Din, Silvia
AU - Hamilton, Fiona
AU - Hulme, Claire
AU - Sanders, Tim
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2024.
PY - 2024/3/28
Y1 - 2024/3/28
N2 - Objective With advancing age comes the increasing prevalence of frailty and increased risk of adverse outcomes (eg, hospitalisation). Evidence for comprehensive geriatric assessment (CGA), a multidimensional holistic model of care, is mixed in community settings. Uncertainties remain, such as the key components of CGA, who delivers it, and the use of technology. This study aimed to understand the perspectives, beliefs and experiences, of both older people and health professionals, to improve the current CGA and explore factors that may impact on CGA delivery in community settings. Design A qualitative interview study was conducted with older people and healthcare professionals (HCPs) identified using a maximum variation strategy. Data were analysed using an abductive analysis approach. The non-adoption, abandonment, scale-up, spread and sustainability framework and the theoretical framework of acceptability guided the categorisation of the codes and identified categories were mapped to the two frameworks. Setting England, UK. Results 27 people were interviewed, constituting 14 older people and 13 HCPs. We identified limitations in the current CGA: a lack of information sharing between different HCPs who deliver CGA; poor communication between older people and their HCPs and a lack of followup as part of CGA. When we discussed the potential for CGA to use technology, HCPs and older people varied in their readiness to engage with it. Conclusions Viable solutions to address gaps in the current delivery of CGA include the provision of training and support to use digital technology and a designated comprehensive care coordinator. The next stage of this research will use these findings, existing evidence and stakeholder engagement, to develop and refine a model of community-based CGA that can be assessed for feasibility and acceptability.
AB - Objective With advancing age comes the increasing prevalence of frailty and increased risk of adverse outcomes (eg, hospitalisation). Evidence for comprehensive geriatric assessment (CGA), a multidimensional holistic model of care, is mixed in community settings. Uncertainties remain, such as the key components of CGA, who delivers it, and the use of technology. This study aimed to understand the perspectives, beliefs and experiences, of both older people and health professionals, to improve the current CGA and explore factors that may impact on CGA delivery in community settings. Design A qualitative interview study was conducted with older people and healthcare professionals (HCPs) identified using a maximum variation strategy. Data were analysed using an abductive analysis approach. The non-adoption, abandonment, scale-up, spread and sustainability framework and the theoretical framework of acceptability guided the categorisation of the codes and identified categories were mapped to the two frameworks. Setting England, UK. Results 27 people were interviewed, constituting 14 older people and 13 HCPs. We identified limitations in the current CGA: a lack of information sharing between different HCPs who deliver CGA; poor communication between older people and their HCPs and a lack of followup as part of CGA. When we discussed the potential for CGA to use technology, HCPs and older people varied in their readiness to engage with it. Conclusions Viable solutions to address gaps in the current delivery of CGA include the provision of training and support to use digital technology and a designated comprehensive care coordinator. The next stage of this research will use these findings, existing evidence and stakeholder engagement, to develop and refine a model of community-based CGA that can be assessed for feasibility and acceptability.
UR - http://www.scopus.com/inward/record.url?scp=85189281606&partnerID=8YFLogxK
UR - http://europepmc.org/abstract/med/38548360
UR - https://pearl.plymouth.ac.uk/context/nm-research/article/1693/viewcontent/e081304.full.pdf
U2 - 10.1136/bmjopen-2023-081304
DO - 10.1136/bmjopen-2023-081304
M3 - Article
C2 - 38548360
AN - SCOPUS:85189281606
SN - 2044-6055
VL - 14
JO - BMJ Open
JF - BMJ Open
IS - 3
M1 - e081304
ER -