GP-led adapted comprehensive geriatric assessment for frail older people: a multi-methods evaluation of the ‘Living Well Assessment’ quality improvement project in Scotland
Background: Evidence to support comprehensive geriatric assessment (CGA) in primary care for frail older people is limited. Aim: To evaluate a GP-led adapted CGA quality improvement project. Design & setting: Multi-methods evaluation in a large practice in Midlothian in Scotland. Method: The...
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| Format: | Article |
| Language: | English |
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Royal College of General Practitioners
2023-03-01
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| Series: | BJGP Open |
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| Online Access: | https://bjgpopen.org/content/7/1/BJGPO.2022.0184 |
| _version_ | 1797850934010707968 |
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| author | Eddie Donaghy Franca Still Helen Frost Julia Lutte Susan D Shenkin Helen E Jones Stewart W Mercer |
| author_facet | Eddie Donaghy Franca Still Helen Frost Julia Lutte Susan D Shenkin Helen E Jones Stewart W Mercer |
| author_sort | Eddie Donaghy |
| collection | DOAJ |
| description | Background: Evidence to support comprehensive geriatric assessment (CGA) in primary care for frail older people is limited. Aim: To evaluate a GP-led adapted CGA quality improvement project. Design & setting: Multi-methods evaluation in a large practice in Midlothian in Scotland. Method: The intervention was conducted by 10 GPs in a practice of approximately 11 000 patients, initially in the patient’s home, and then remotely (by telephone or video consultation) during the COVID-19 pandemic. Evaluation included a patient questionnaire, and qualitative interviews with GPs delivering the Living Well Assessment (LWA), analysed by thematic analysis. Results: A total of 165/220 (75%) patients responded to the survey, of which 86% reported a ‘very good experience’ of the LWA. The method of delivery did not significantly influence this although most (58%) stated a preference for face-to-face consultation. For the 31% who preferred remote LWA, most (23%) preferred telephone to video consultation (8%). Problems in remote consultations related to technical issues (video), poor vision (video), or deafness (telephone or video). GPs felt that home-based LWAs had real benefits but switching to remote during the pandemic had proven feasible. Concerns included potential increase in GP workload owing to the LWA and whether it was an efficient use of GPs’ time. Conclusion: GP-led adapted CGA was feasible in a large practice, even during the pandemic, and highly valued by frail patients. Questions regarding efficient use of GPs’ time, effectiveness in terms of important patient outcomes and impact, and cost-effectiveness, requires further investigation in a larger study. |
| first_indexed | 2024-04-09T19:08:32Z |
| format | Article |
| id | doaj.art-cffab332b0cf475394a877dffa3adb37 |
| institution | Directory Open Access Journal |
| issn | 2398-3795 |
| language | English |
| last_indexed | 2024-04-09T19:08:32Z |
| publishDate | 2023-03-01 |
| publisher | Royal College of General Practitioners |
| record_format | Article |
| series | BJGP Open |
| spelling | doaj.art-cffab332b0cf475394a877dffa3adb372023-04-07T07:53:59ZengRoyal College of General PractitionersBJGP Open2398-37952023-03-017110.3399/BJGPO.2022.0184GP-led adapted comprehensive geriatric assessment for frail older people: a multi-methods evaluation of the ‘Living Well Assessment’ quality improvement project in ScotlandEddie Donaghy0Franca Still1Helen Frost2Julia Lutte3Susan D Shenkin4Helen E Jones5Stewart W Mercer6Usher Institute, University of Edinburgh, Edinburgh, UKMedical School, University of Edinburgh, Edinburgh, UKUsher Institute, University of Edinburgh, Edinburgh, UKPenicuik Medical Practice, Midlothian, Penicuik, UKUsher Institute, University of Edinburgh, Edinburgh, UKDepartment of Medicine of the Elderly, Western General Hospital, NHS Lothian, Edinburgh, UKAdvanced Care Research Centre, Usher Institute, University of Edinburgh, Edinburgh, UKBackground: Evidence to support comprehensive geriatric assessment (CGA) in primary care for frail older people is limited. Aim: To evaluate a GP-led adapted CGA quality improvement project. Design & setting: Multi-methods evaluation in a large practice in Midlothian in Scotland. Method: The intervention was conducted by 10 GPs in a practice of approximately 11 000 patients, initially in the patient’s home, and then remotely (by telephone or video consultation) during the COVID-19 pandemic. Evaluation included a patient questionnaire, and qualitative interviews with GPs delivering the Living Well Assessment (LWA), analysed by thematic analysis. Results: A total of 165/220 (75%) patients responded to the survey, of which 86% reported a ‘very good experience’ of the LWA. The method of delivery did not significantly influence this although most (58%) stated a preference for face-to-face consultation. For the 31% who preferred remote LWA, most (23%) preferred telephone to video consultation (8%). Problems in remote consultations related to technical issues (video), poor vision (video), or deafness (telephone or video). GPs felt that home-based LWAs had real benefits but switching to remote during the pandemic had proven feasible. Concerns included potential increase in GP workload owing to the LWA and whether it was an efficient use of GPs’ time. Conclusion: GP-led adapted CGA was feasible in a large practice, even during the pandemic, and highly valued by frail patients. Questions regarding efficient use of GPs’ time, effectiveness in terms of important patient outcomes and impact, and cost-effectiveness, requires further investigation in a larger study.https://bjgpopen.org/content/7/1/BJGPO.2022.0184comprehensive geriatric assessmentfrailtyagedgeneral practiceprimary healthcare |
| spellingShingle | Eddie Donaghy Franca Still Helen Frost Julia Lutte Susan D Shenkin Helen E Jones Stewart W Mercer GP-led adapted comprehensive geriatric assessment for frail older people: a multi-methods evaluation of the ‘Living Well Assessment’ quality improvement project in Scotland BJGP Open comprehensive geriatric assessment frailty aged general practice primary healthcare |
| title | GP-led adapted comprehensive geriatric assessment for frail older people: a multi-methods evaluation of the ‘Living Well Assessment’ quality improvement project in Scotland |
| title_full | GP-led adapted comprehensive geriatric assessment for frail older people: a multi-methods evaluation of the ‘Living Well Assessment’ quality improvement project in Scotland |
| title_fullStr | GP-led adapted comprehensive geriatric assessment for frail older people: a multi-methods evaluation of the ‘Living Well Assessment’ quality improvement project in Scotland |
| title_full_unstemmed | GP-led adapted comprehensive geriatric assessment for frail older people: a multi-methods evaluation of the ‘Living Well Assessment’ quality improvement project in Scotland |
| title_short | GP-led adapted comprehensive geriatric assessment for frail older people: a multi-methods evaluation of the ‘Living Well Assessment’ quality improvement project in Scotland |
| title_sort | gp led adapted comprehensive geriatric assessment for frail older people a multi methods evaluation of the living well assessment quality improvement project in scotland |
| topic | comprehensive geriatric assessment frailty aged general practice primary healthcare |
| url | https://bjgpopen.org/content/7/1/BJGPO.2022.0184 |
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