Validation of the Portuguese Version of the Risk Instrument for Screening in the Community (RISC) Among Older Patients in Primary Care in Northern Portugal
Background: Aging is associated with an increase in adverse health outcomes for older people. Short screening instruments that easily and quickly identify those at highest risk can enable decision-makers to anticipate future needs, allocate scarce resources and act to minimize risk. The Risk Instrum...
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Frontiers Media S.A.
2021-08-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2021.614935/full |
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| author | Sara Santos Sara Santos Rónán O'Caoimh Laetitia Teixeira Laetitia Teixeira Sara Alves Sara Alves William Molloy Constança Paúl Constança Paúl |
| author_facet | Sara Santos Sara Santos Rónán O'Caoimh Laetitia Teixeira Laetitia Teixeira Sara Alves Sara Alves William Molloy Constança Paúl Constança Paúl |
| author_sort | Sara Santos |
| collection | DOAJ |
| description | Background: Aging is associated with an increase in adverse health outcomes for older people. Short screening instruments that easily and quickly identify those at highest risk can enable decision-makers to anticipate future needs, allocate scarce resources and act to minimize risk. The Risk Instrument for Screening in the Community (RISC) is a brief (2–5 min) Likert scale that scores one-year risk of institutionalization, hospitalization and death from low (1/5) to severe (5/5).Objectives: To externally validate the RISC, scored by general practitioners (GP's), in primary care in Northern Portugal.Methods: The RISC was translated and culturally adapted to Portuguese. A cohort of 457 older adults (aged ≥65) under active follow-up with their GP's were screened. Outcomes at one-year were recorded. Accuracy was determined from the area under the curve (AUC) of receiver operating curve analysis.Results: The mean age of participants was 75.2 years; 57% were female. The proportion identified as being at maximum risk (RISC scores of 3-5/5) of institutionalization, hospitalization and death, were 14.9, 52.4 and 38.4%, respectively. At follow-up 2% (10/431) were institutionalized, 18.6% (84/451) were hospitalized and 3% (14/456) died. Those who were institutionalized (p = 0.021), hospitalized (p = 0.012) or dead (p < 0.001) at one-year were significantly older. Those living alone were more likely to be institutionalized (p = 0.007). The RISC showed fair accuracy in predicting hospitalization (AUC of 0.62 [95% CI: 0.55–0.69]) and good accuracy for Institutionalization (AUC of 0.79 [95% CI: 0.62–0.96]) and death (AUC of 0.77 [95% CI: 0.65–0.88]).Conclusions: The Portuguese version of the RISC accurately predicted institutionalization and death at one-year but like most short screens was less able to predict hospitalization. Given its brevity, the RISC is useful for quickly identifying and stratifying those at increased risk in primary care. |
| first_indexed | 2024-12-16T17:48:23Z |
| format | Article |
| id | doaj.art-23da206df32148a29f4366cc81618a16 |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-12-16T17:48:23Z |
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| series | Frontiers in Public Health |
| spelling | doaj.art-23da206df32148a29f4366cc81618a162022-12-21T22:22:23ZengFrontiers Media S.A.Frontiers in Public Health2296-25652021-08-01910.3389/fpubh.2021.614935614935Validation of the Portuguese Version of the Risk Instrument for Screening in the Community (RISC) Among Older Patients in Primary Care in Northern PortugalSara Santos0Sara Santos1Rónán O'Caoimh2Laetitia Teixeira3Laetitia Teixeira4Sara Alves5Sara Alves6William Molloy7Constança Paúl8Constança Paúl9Abel Salazar Institute of Biomedical Sciences, University of Porto, Porto, PortugalCINTESIS, Faculty of Medicine, University of Porto, Porto, PortugalCentre for Gerontology and Rehabilitation, St Finbarrs Hospital, University College Cork, Cork, IrelandAbel Salazar Institute of Biomedical Sciences, University of Porto, Porto, PortugalCINTESIS, Faculty of Medicine, University of Porto, Porto, PortugalAbel Salazar Institute of Biomedical Sciences, University of Porto, Porto, PortugalCINTESIS, Faculty of Medicine, University of Porto, Porto, PortugalCentre for Gerontology and Rehabilitation, St Finbarrs Hospital, University College Cork, Cork, IrelandAbel Salazar Institute of Biomedical Sciences, University of Porto, Porto, PortugalCINTESIS, Faculty of Medicine, University of Porto, Porto, PortugalBackground: Aging is associated with an increase in adverse health outcomes for older people. Short screening instruments that easily and quickly identify those at highest risk can enable decision-makers to anticipate future needs, allocate scarce resources and act to minimize risk. The Risk Instrument for Screening in the Community (RISC) is a brief (2–5 min) Likert scale that scores one-year risk of institutionalization, hospitalization and death from low (1/5) to severe (5/5).Objectives: To externally validate the RISC, scored by general practitioners (GP's), in primary care in Northern Portugal.Methods: The RISC was translated and culturally adapted to Portuguese. A cohort of 457 older adults (aged ≥65) under active follow-up with their GP's were screened. Outcomes at one-year were recorded. Accuracy was determined from the area under the curve (AUC) of receiver operating curve analysis.Results: The mean age of participants was 75.2 years; 57% were female. The proportion identified as being at maximum risk (RISC scores of 3-5/5) of institutionalization, hospitalization and death, were 14.9, 52.4 and 38.4%, respectively. At follow-up 2% (10/431) were institutionalized, 18.6% (84/451) were hospitalized and 3% (14/456) died. Those who were institutionalized (p = 0.021), hospitalized (p = 0.012) or dead (p < 0.001) at one-year were significantly older. Those living alone were more likely to be institutionalized (p = 0.007). The RISC showed fair accuracy in predicting hospitalization (AUC of 0.62 [95% CI: 0.55–0.69]) and good accuracy for Institutionalization (AUC of 0.79 [95% CI: 0.62–0.96]) and death (AUC of 0.77 [95% CI: 0.65–0.88]).Conclusions: The Portuguese version of the RISC accurately predicted institutionalization and death at one-year but like most short screens was less able to predict hospitalization. Given its brevity, the RISC is useful for quickly identifying and stratifying those at increased risk in primary care.https://www.frontiersin.org/articles/10.3389/fpubh.2021.614935/fullprimary careolder peopledeathhospitalizationinstitutionalizationrisk |
| spellingShingle | Sara Santos Sara Santos Rónán O'Caoimh Laetitia Teixeira Laetitia Teixeira Sara Alves Sara Alves William Molloy Constança Paúl Constança Paúl Validation of the Portuguese Version of the Risk Instrument for Screening in the Community (RISC) Among Older Patients in Primary Care in Northern Portugal Frontiers in Public Health primary care older people death hospitalization institutionalization risk |
| title | Validation of the Portuguese Version of the Risk Instrument for Screening in the Community (RISC) Among Older Patients in Primary Care in Northern Portugal |
| title_full | Validation of the Portuguese Version of the Risk Instrument for Screening in the Community (RISC) Among Older Patients in Primary Care in Northern Portugal |
| title_fullStr | Validation of the Portuguese Version of the Risk Instrument for Screening in the Community (RISC) Among Older Patients in Primary Care in Northern Portugal |
| title_full_unstemmed | Validation of the Portuguese Version of the Risk Instrument for Screening in the Community (RISC) Among Older Patients in Primary Care in Northern Portugal |
| title_short | Validation of the Portuguese Version of the Risk Instrument for Screening in the Community (RISC) Among Older Patients in Primary Care in Northern Portugal |
| title_sort | validation of the portuguese version of the risk instrument for screening in the community risc among older patients in primary care in northern portugal |
| topic | primary care older people death hospitalization institutionalization risk |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2021.614935/full |
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