Mieke Deschodt1,2, Anthony Jeuris3, Bastiaan Van Grootven4,5, Eline Van Waerebeek6, Evie Gantois5, Johan Flamaing7,8, Anja Velghe9. 1. Department of Public Health and Primary Care, Gerontology and Geriatrics, KU Leuven, Leuven, Belgium. mieke.deschodt@kuleuven.be. 2. Department of Public Health, Nursing Science, University of Basel, Basel, Switzerland. mieke.deschodt@kuleuven.be. 3. Jessa Ziekenhuis, Hasselt, Belgium. 4. Department of Public Health and Primary Care, Academic Center for Nursing and Midwifery, KU Leuven, Leuven, Belgium. 5. Research Foundation Flanders (FWO), Brussels, Belgium. 6. , Ghent, Belgium. 7. Department of Public Health and Primary Care, Gerontology and Geriatrics, KU Leuven, Leuven, Belgium. 8. Geriatrics Department, University Hospitals Leuven, Leuven, Belgium. 9. Geriatrics Department, University Hospitals Ghent, Ghent, Belgium.
Abstract
PURPOSE: Inpatient geriatric consultation teams (IGCTs) provide recommendations for the care of older patients hospitalized on non-geriatric wards based on comprehensive geriatric assessment. The lack of adherence to their recommendations hinders the potential impact of IGCTs. We evaluated the adherence to IGCT recommendations and determined which team and recommendation characteristics are related to higher adherence rates. METHODS: Multicenter observational study in older adults aged ≥ 75 years admitted to an acute non-geriatric ward. Demographic and adherence data were collected for 30 consecutive patients. A cross-sectional survey mapped team and organizational characteristics of the participating IGCTs. RESULTS: Analyses were conducted in 278 patients (51.4% male, mean age 82.5 years, and median length of stay 10 days). There was a median number of 3 recommendations (range 1-13) per patient. The overall adherence rate was 69.7%. Recommendations related to 'social status' (82.4%) and 'functional status/mobility' (73.3%) were best adhered to. Recommendations related to 'medication' (53.2%) and 'nutritional status' (59.1%) were least adhered to. Adherence rates increased if recommendations were given to allied health professionals (OR = 6.37, 95% CI = 1.15-35.35) or by more experienced IGCTs (OR = 1.34, 95% CI = 1.04-1.72) and decreased when more recommendations were given (OR = 0.51, 95% CI = 0.33-0.80). CONCLUSION: Adherence rate to IGCT recommendations increased if given to allied health professionals or by more experienced IGCTs and when fewer recommendations were given. Study replication in an international multicenter study with a larger number of centers and evaluating the quality of the recommendations is suggested.
PURPOSE: Inpatient geriatric consultation teams (IGCTs) provide recommendations for the care of older patients hospitalized on non-geriatric wards based on comprehensive geriatric assessment. The lack of adherence to their recommendations hinders the potential impact of IGCTs. We evaluated the adherence to IGCT recommendations and determined which team and recommendation characteristics are related to higher adherence rates. METHODS: Multicenter observational study in older adults aged ≥ 75 years admitted to an acute non-geriatric ward. Demographic and adherence data were collected for 30 consecutive patients. A cross-sectional survey mapped team and organizational characteristics of the participating IGCTs. RESULTS: Analyses were conducted in 278 patients (51.4% male, mean age 82.5 years, and median length of stay 10 days). There was a median number of 3 recommendations (range 1-13) per patient. The overall adherence rate was 69.7%. Recommendations related to 'social status' (82.4%) and 'functional status/mobility' (73.3%) were best adhered to. Recommendations related to 'medication' (53.2%) and 'nutritional status' (59.1%) were least adhered to. Adherence rates increased if recommendations were given to allied health professionals (OR = 6.37, 95% CI = 1.15-35.35) or by more experienced IGCTs (OR = 1.34, 95% CI = 1.04-1.72) and decreased when more recommendations were given (OR = 0.51, 95% CI = 0.33-0.80). CONCLUSION: Adherence rate to IGCT recommendations increased if given to allied health professionals or by more experienced IGCTs and when fewer recommendations were given. Study replication in an international multicenter study with a larger number of centers and evaluating the quality of the recommendations is suggested.
Entities:
Keywords:
Geriatric assessment; Hospital; Referral and consultation; Treatment adherence and compliance
Authors: Camilla L Wong; Raghda Al Atia; Amanda McFarlan; Holly Y Lee; Christina Valiaveettil; Barbara Haas Journal: Can J Surg Date: 2016-10-01 Impact factor: 2.089