Models of Approach to Outpatient Older Persons Care
Science Journal of Public Health
Volume 2, Issue 5, September 2014, Pages: 447-453
Received: Aug. 12, 2014; Accepted: Aug. 28, 2014; Published: Sep. 20, 2014
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Célia Pereira Caldas, Third Age Open University / Rio de Janeiro State University, Rua São Francisco Xavier 524, Bloco F, Sala 10150, Maracanã – Rio de Janeiro, RJ. Brazil. CEP 20559-900
Renato Peixoto Veras, Third Age Open University/ Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
Luciana Branco da Motta, Third Age Open University/ Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
Ricardo Carreño Siqueira, Third Age Open University/ Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
Renata de Freitas Corrêa, Third Age Open University/ Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
Marcelo de Jesus Carlos, Third Age Open University/ Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
Ana Carolina Lima Cavaletti Guerra, Third Age Open University/ Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
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Background: The aging of the population has generated discussions on the needs and unique characteristics of the users of health systems. In this context, the frailty has been used as a guide in managing health care for older adults and specific intervention has shown itself to be effective as much for the diagnosis of illnesses as the improved functioning and satisfaction of the patient and the reduction of mortality. Aims and objetive: The aim of this study was to become familiar with approaches to outpatient older people care for frail older adults. A critical review was conducted evaluating the effectiveness of these models and researchers looked for methods developed in outpatient facilities by interprofessional teams. Conclusions: The models that met our criteria for eligibility presented interprofessional teams composed of geriatricians, nurses, social workers, physiotherapists, occupational therapists, speech therapists, nutritionists and pharmacists. All of the models offered managed care of their patients and the professional who carry out these tasks are mainly nurses, but also social workers, or a primary care physician. Relevance to Clinical Practice: Our results showed that the configuration of a specialized outpatient model in the care of the frail older person is a recent phenomenon, with benefits such as reduced polypharmacy and decreases in functional loss, resulting in a greater quality of life for the users.
Outpatient Care, Frailty, Interdisciplinary Health Teams, Ambulatory Health Center
To cite this article
Célia Pereira Caldas, Renato Peixoto Veras, Luciana Branco da Motta, Ricardo Carreño Siqueira, Renata de Freitas Corrêa, Marcelo de Jesus Carlos, Ana Carolina Lima Cavaletti Guerra, Models of Approach to Outpatient Older Persons Care, Science Journal of Public Health. Vol. 2, No. 5, 2014, pp. 447-453. doi: 10.11648/j.sjph.20140205.21
C. Bielaszka-DuVernay, “The ‘GRACE’ model: in-home assessments lead to better care for dual eligible,” Health Affairs (Project Hope), vol. 30, pp. 431–434, 2011.
S. R. Counsell, C. M. Callahan, D. O. Clark, W. Tu, A. B. Buttar, T. E. Stump, G. D. Ricketts, “Geriatric care management for low-income seniors: a randomized controlled trial,” JAMA : The Journal of the American Medical Association, vol. 298, pp. 2623–33, 2007.
R. A. Lourenço, C. S. F. Martins, M. A. S. Sanchez, R. P. Veras, “Assistência ambulatorial geriátrica: hierarquização da demanda,” Revista de Saúde Pública, vol. 39, pp. 311–318, 2005.
R. P. Veras, “Gerenciamento de doença crônica: equívoco para o grupo etário dos idosos,” Revista de Saúde Pública, vol. 46, pp. 929–934, 2012.
G. Abellan Van Kan, A. Sinclair, S. Andrieu, M. Olde Rikkert, G. Gambassi, and B. Vellas, “The geriatric minimum data set for clinical trials (GMDS),” The Journal of Nutrition, Health & Aging, vol. 12, pp. 197–200, 2008.
B. Walsh, H. Roberts, J. Hopkinson, “Emergency hospital admissions for ill-defined conditions amongst older people: a review of the literature,” International journal of older people nursing, vol. 2, pp. 270–7, 2007.
J. McCusker, J. Verdon, P. Tousignant, L. P. de Courval, N. Dendukuri, E. Belzile, “Rapid emergency department intervention for older people reduces risk of functional decline: results of a multicenter randomized trial,” Journal of the American Geriatrics Society, vol. 49, pp. 1272–81, 2001.
R. E. Pel-Littel, M. J. Schuurmans, M. H. Emmelot-Vonk, H. J. J. Verhaar, “Frailty: defining and measuring of a concept,” The Journal of Nutrition, Health & Aging, vol. 13, pp. 390–4, 2009.
J. Walston, E. C. Hadley, L. Ferrucci, J. M. Guralnik, A. B. Newman, S. A. Studenski, W. B. Ershler, T. Harris, L. P. Fried, “Research agenda for frailty in older adults: toward a better understanding of physiology and etiology: summary from the American Geriatrics Society/National Institute on Aging Research Conference on Frailty in Older Adults,” Journal of the American Geriatrics Society, vol. 54, pp. 991–1001, 2006.
J. Ploeg, J. Feightner, B. Hutchison, C. Patterson, C. Sigouin, M. Gauld, “Effectiveness of preventive primary care outreach interventions aimed at older people: meta-analysis of randomized controlled trials,” Canadian Family Physician Médecin de Famille Canadien, vol. 51, pp. 1244–5, 2005.
N. J. Cordato, S. Saha, M. A. Price, “Geriatric interventions: the evidence base for comprehensive health care services for older people,” Australian Health Review: A Publication of the Australian Hospital Association, vol. 29, pp. 151–5, 2005.
E. Rosted, L. Wagner, C. Hendriksen, I. Poulsen, “Geriatric nursing assessment and intervention in an emergency department: a pilot study,” International Journal of Older People Nursing, vol. 7, pp. 141–151, 2012.
S. Eloranta, S. Arve, P. Routasalo, “Multiprofessional collaboration promoting home care clients’ personal resources: perspectives of older clients,” International journal of older people nursing, vol. 3, pp. 88–95, 2008.
R. Daniels, S. Metzelthin, E. Rossum, L. Witte, W. Heuvel, “Interventions to prevent disability in frail community-dwelling older persons: an overview,” European Journal of Ageing, vol. 7, pp. 37–55, 2010.
N. Bleijenberg, I. Drubbel, V. H. Ten Dam, M. E. Numans, M. J. Schuurmans, N. J. de Wit, “Proactive and integrated primary care for frail older people: design and methodological challenges of the Utrecht primary care PROactive frailty intervention trial (U-PROFIT),” BMC Geriatrics, vol. 12, pp. 16, 2012.
C. Boult, L. B. Boult, L. Morishita, B. Dowd, R. L. Kane, C. F. Urdangarin, “A randomized clinical trial of outpatient geriatric evaluation and management,” Journal of the American Geriatrics Society, vol. 49, pp. 351–359, 2001.
E. A. Coleman, L. C. Grothaus, N. Sandhu, E. H. Wagner, “Chronic care clinics: a randomized controlled trial of a new model of primary care for frail older adults,” Journal of the American Geriatrics Society, vol. 47, pp. 775–83, 1999.
L. K. Evans, J. Yurkow, E. L. Siegler, “The CARE Program: a nurse-managed collaborative outpatient program to improve function of frail older people. Collaborative Assessment and Rehabilitation for Elders,” Journal of the American Geriatrics Society, vol. 43, pp. 1155–60, 1995.
M.-H. Lin, C.-L. Liu, L.-N. Peng, Y.-T. Chen, L.-K. Chen, “Demographic characteristics and clinical benefits of outpatient geriatric evaluation and management service in Taiwan,” Archives of Gerontology and Geriatrics, vol. 55, pp. 42–4, 2012.
S. Coppola, C. A. Rosemond, N. Greger-Holt, F. G. Soltys, L. C. Hanson, M. A. Snider, J. Busby-Whitehead, “Arena assessment: evolution of teamwork for frail older adults,” Top Geriatr Rehabil, vol. 17, pp. 13–28, 2002.
I. N. Fabbricotti, B. Janse, W. M. Looman, R. de Kuijper, J. D. H. van Wijngaarden, A. Reiffers, “Integrated care for frail elderly compared to usual care: a study protocol of a quasi-experiment on the effects on the frail elderly, their caregivers, health professionals and health care costs,” BMC Geriatrics, vol. 13, pp. 31, 2013.
A. L. Mazya, J. Eckerblad, T. Jaarsma, I. Hellström, B. Krevers, A. Milberg, M. Unosson, A. Westöö, A. Ekdahl, “The Ambulatory Geriatric Assessment – a Frailty Intervention Trial (AGe-FIT) – a randomised controlled trial aimed to prevent hospital readmissions and functional deterioration in high risk older adults: a study protocol,” European Geriatric Medicine, pp. 242–247, 2013.
J. Subra, S. Gillette-Guyonnet, M. Cesari, S. Oustric, B. Vellas, “The integration of frailty into clinical practice: preliminary results from the Gérontopôle,” The Journal of Nutrition, Health & Aging, vol. 16, pp. 714–20, 2012.
A. Lowenstein, “A case management demonstration project for the frail elderly in Israel,” Care Management Journals : Journal of Case Management; The Journal of Long Term Home Health Care, vol. 2, pp. 5–14, 2000.
H. H. Handoll, I. D. Cameron, J. C. Mak, T. P. Finnegan, “Multidisciplinary rehabilitation for older people with hip fractures,” The Cochrane Database of Systematic Reviews, vol. 7, pp.CD007125, 2009.
H. Hasson, S. Blomberg, A. Dunér, “Fidelity and moderating factors in complex interventions: a case study of a continuum of care program for frail elderly people in health and social care,” Implementation Science: IS, vol. 7, pp. 23–34, 2012.
M. E. Keough, T. S. Field, J. H. Gurwitz, “A model of community-based interdisciplinary team training in the care of the frail elderly,” Academic Medicine : Journal of the Association of American Medical Colleges, vol. 77, pp. 936, 2002.
N. Fairhall, C. Aggar, S. E. Kurrle, C. Sherrington, S. Lord, K. Lockwood, N. Monaghan, I. D. Cameron, “Frailty Intervention Trial (FIT),” BMC Geriatrics, vol. 8, pp. 27, 2008.
R. J. F. Melis, E. Adang, S. Teerenstra, M. I. van Eijken, A. Wilmo, T. van Achterberg, E. H. van de Lisdonk, M. G. Rikkert, “Cost-effectiveness of a multidisciplinary intervention model for community-dwelling frail older people,” The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, vol. 63, pp. 275–282, 2008.
M. E. Muntinga, E. O. Hoogendijk, K. M. van Leeuwen, H. P. J. van Hout, J. W. R. Twisk, H. E. van der Horst, G. Nijpels, A. P. D. Jansen, “Implementing the chronic care model for frail older adults in the Netherlands: study protocol of ACT (frail older adults: care in transition),” BMC Geriatrics, vol. 12, pp. 19–29, 2012.
N. Van den Berg, C. Meinke, M. Matzke, R. Heymann, S. Flessa, W. Hoffmann, “Delegation of GP-home visits to qualified practice assistants: assessment of economic effects in an ambulatory healthcare centre,” BMC Health Services Research, vol. 10, pp. 155–163, 2010.
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