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Does comprehensive geriatric assessment (CGA) in an outpatient care setting affect the causes of death and the quality of palliative care? A subanalysis of the age-FIT study
Region Östergötland.
Lund Hosp, Sweden; KI, Sweden.
Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in East Östergötland, Center of Palliative Care.ORCID iD: 0000-0002-9606-3238
2019 (English)In: European Geriatric Medicine, ISSN 1878-7649, E-ISSN 1878-7657, Vol. 10, no 3, p. 455-462Article in journal (Refereed) Published
Abstract [en]

Key summary pointsAimDoes comprehensive geriatric assessment (CGA) affect the causes of death and the quality of palliative care when patients receive care at the end of life when in an outpatient care setting compared to usual care?FindingsCGA does not affect the causes of death. CGA affects the frequency of referral to specialised palliative care teams, but CGA does not affect the quality of palliative care given to the patients. These effects are measured in outpatient care settings and in comparison with usual care.MessageFurther studies are needed to evaluate the CGA effects on causes of death and palliative care quality in outpatient care settings. AbstractPurposeThe purposes of this study were to retrospectively study whether comprehensive geriatric assessment (CGA) given to community-dwelling old patients with high health care usage has effects regarding: (1) the cause of death and (2) the quality of the provided palliative care when compared to patients without CGA-based care.MethodThis study includes secondary data from a randomised controlled trial (RCT) with 382 participants that took place in the periods 2011-2013. The present study examines all electronical medical records (EMR) from the deceased patients in the original study regarding cause of death [intervention group (IG) N=51/control group (CG) N=66] and quality of palliative care (IG N=33/CG N=41). Descriptive and comparative statistics were produced and the significance level was set at pamp;lt;0.05.ResultsThe causes of death in both groups were dominated by cardiovascular and cerebrovascular diseases with no statistical difference between the groups. Patients in the intervention group had a higher degree of support from specialised palliative care teams than had the control group (p=0.01).ConclusionThe present study in an outpatient context cannot prove any effects of CGA on causes of death. The study shows that CGA in outpatient care means a higher rate of specialised palliative care, but the study cannot show any effects on the palliative quality parameters measured. Further studies with statistical power are needed.

Place, publisher, year, edition, pages
SPRINGER , 2019. Vol. 10, no 3, p. 455-462
Keywords [en]
Comprehensive geriatric assessment; Palliative care; Outpatient geriatric care; Mortality; Cause of death; End of life
National Category
Geriatrics
Identifiers
URN: urn:nbn:se:liu:diva-158050DOI: 10.1007/s41999-019-00198-wISI: 000469041000013OAI: oai:DiVA.org:liu-158050DiVA, id: diva2:1329208
Note

Funding Agencies|Region Ostergotland from the Agreements Concerning research and education of doctors; Local Health Care Eastern Ostergotland

Available from: 2019-06-24 Created: 2019-06-24 Last updated: 2019-11-04

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