Atención Geriátrica Integrada Comunitaria (GERiCOM Next Generation Project)
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Development of telehealth principles and guidelines for older adults: A modified Delphi approach - Wardlow - 2023 - Journal of the American Geriatrics Society - Wiley Online Library

Development of telehealth principles and guidelines for older adults: A modified Delphi approach - Wardlow - 2023 - Journal of the American Geriatrics Society - Wiley Online Library | Atención Geriátrica Integrada Comunitaria (GERiCOM Next Generation Project) | Scoop.it

.- Clinicians are increasingly providing telehealth care to older adults despite a lack of comprehensive guidance on age-friendly implementation and practice.

.- The reach of telehealth for older adults remains limited due to several factors, including existing or perceived challenges around physical and cognitive limitations, and a lack of comprehensive guidance on older-adult- focused implementation.

.- This is the first comprehensive set of provider- focused telehealth principles and guidelines, developed by aging and telehealth experts, to address the specific needs of an aging population.

Sergio Ariño Blasco's insight:

Telemonitorización dirigida a personas confinados al hogar, sin acceso a transporte, problemas de movilidad, ubicacion geográfica remota...

 

Las recomendaciones del The Collaborative for Telehealth and Aging (C4TA) constituido por proveedores, expertos en geriatria, telemedicina y organizaciones defensoras de ancianos; se orienta a una atención centrada en el paciente, equitativas, accesibles, integradas y coordinadas entre personas y sistemas. .

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The Integrated Care Team: A primary care based-approach to support older adults with complex health needs - George A. Heckman, Sarah Gimbel, Chantelle Mensink, Brittany Kroetsch, Aaron Jones, Anoos...

The Integrated Care Team: A primary care based-approach to support older adults with complex health needs - George A. Heckman, Sarah Gimbel, Chantelle Mensink, Brittany Kroetsch, Aaron Jones, Anoos... | Atención Geriátrica Integrada Comunitaria (GERiCOM Next Generation Project) | Scoop.it

Many older adults have complex needs and experience high rates of acute care use and institutionalization. Comprehensive Geriatric Assessment (CGA) is a specialized multidimensional interprofessional intervention to prevent such outcomes, but access to CGA in the community is limited. The Integrated Care Team (ICT) is a proactive case-finding intervention to support older adults with complex needs in primary care. The ICT provides nurse practitioner-led shared-care supported by a pharmacist, family physician, and geriatrician.

 

Patients rostered to the NVFHT access the ICT either through family physician referral, identification of multiple ED visits or falls, or case-finding using the interRAI Assessment Urgency Algorithm (AUA). The AUA is a brief questionnaire assessing functional capacity, shortness of breath, self-rated health, mood, continence, and caregiver burden. Scores range from 1 to 6, with higher scores indicating a more urgent need for CGA. Referred patients and those with AUA scores of 4 to 6 undergo a CGA.

Sergio Ariño Blasco's insight:

GERiCOM canadiense (y usan el AUA)

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The role of Department of Veterans Affairs community‐based outpatient clinics in enhancing rural access to geriatrics telemedicine specialty care - Pimentel - 2024 - Journal of the American Geriatr...

Journal of the American Geriatrics Society (JAGS) is the go-to geriatrics journal for clinical aging research including education, clinical practice and public policy.
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June 23, 12:10 PM
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NHS England » Same day emergency care

NHS England » Same day emergency care | Atención Geriátrica Integrada Comunitaria (GERiCOM Next Generation Project) | Scoop.it

SDEC NHS

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April 25, 2:56 AM
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Risk Assessment and Prevention of Falls in Older Community-Dwelling Adults: A Review | Geriatrics | JAMA | JAMA Network

Risk Assessment and Prevention of Falls in Older Community-Dwelling Adults: A Review | Geriatrics | JAMA | JAMA Network | Atención Geriátrica Integrada Comunitaria (GERiCOM Next Generation Project) | Scoop.it
This Review summarizes current best practices for risk stratification, clinical assessment, and selection of risk reduction interventions for falls in community-dwelling older adults.
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Guidance on Energy and Macronutrients across the Life Span | New England Journal of Medicine

Poor nutrition is a major risk factor for disease. In this first review in a new series on nutrition, the authors provide an overview of nutritional guidance, with a focus on energy and macronutrients.
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Maintaining independence in older adults | The BMJ

Maintaining independence in older adults | The BMJ | Atención Geriátrica Integrada Comunitaria (GERiCOM Next Generation Project) | Scoop.it
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April 4, 8:00 AM
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Key Issues as Wearable Digital Health Technologies Enter Clinical Care | New England Journal of Medicine

The authors address the issues that must be confronted if we are to integrate the use of wearable digital health technologies into clinical care in a way that provides an enduring benefit to patients.
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STOPPFrail (Screening Tool of Older Persons Prescriptions in Frail adults with limited life expectancy): consensus validation | Age and Ageing | Oxford Academic

STOPPFrail (Screening Tool of Older Persons Prescriptions in Frail adults with limited life expectancy): consensus validation | Age and Ageing | Oxford Academic | Atención Geriátrica Integrada Comunitaria (GERiCOM Next Generation Project) | Scoop.it

STOPPFrail comprises 27 criteria relating to medications that are potentially inappropriate in frail older patients with limited life expectancy. STOPPFrail may assist physicians in deprescribing medications in these patients.

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Self-Reported Frailty Screening Tools: Comparing Construct Validity of the Frailty Phenotype Questionnaire and FRAIL        J Am Med Dir Assoc. 2022;23(11):1870 e1- e7.

Self-Reported Frailty Screening Tools: Comparing Construct Validity of the Frailty Phenotype Questionnaire and FRAIL        J Am Med Dir Assoc. 2022;23(11):1870 e1- e7. | Atención Geriátrica Integrada Comunitaria (GERiCOM Next Generation Project) | Scoop.it

Chia JQ et al. examined the construct validity of 2 self-reported frailty questionnaires, the Frailty Phenotype Questionnaire (FPQ) and FRAIL, against the Cardiovascular Health Study frailty phenotype (CHS-FP).

Sergio Ariño Blasco's curator insight, November 15, 2022 1:19 PM

Los cuestionarios autoadministrados (selfreported) están cobrando protagonismo en estos últimos años, probablemente favorecidos por los condicionantes de la pandemia y de la telemedicina.

En población residente en la comunidad el instrumento FPQ muestra un poder discriminante y valor predictivo superiores al instrumento FRAIL para identificación de fragilidad. 

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What's next for Hospital at Home Programs in the United States: A clarion call for permanent, person‐centered solutions - Brody - 2023 - Journal of the American Geriatrics Society - Wiley Online Li...

What's next for Hospital at Home Programs in the United States: A clarion call for permanent, person‐centered solutions - Brody - 2023 - Journal of the American Geriatrics Society - Wiley Online Li... | Atención Geriátrica Integrada Comunitaria (GERiCOM Next Generation Project) | Scoop.it

The 4M Framework could be a cornerstone of quality metrics for the HaH population. Potential patient- reported measures include a return to prior function, receiving enough support to perform self-care during the HaH stay, and effective transitional care education, over- sight, and handoffs. Adding to this pragmatically collected patient-centered measures such as deprescribing and simplifying medication regimens, documentation of an advance care planning or serious illness communication discussion, and emergent transfers could provide a multi- layered PCC quality and safety approach all the while minimizing regulatory burdens and expense.

 

Sergio Ariño Blasco's insight:

The KISS principle... Keep it simple

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Development of telehealth principles and guidelines for older adults: A modified Delphi approach - Wardlow - 2023 - Journal of the American Geriatrics Society - Wiley Online Library

Development of telehealth principles and guidelines for older adults: A modified Delphi approach - Wardlow - 2023 - Journal of the American Geriatrics Society - Wiley Online Library | Atención Geriátrica Integrada Comunitaria (GERiCOM Next Generation Project) | Scoop.it

.- Clinicians are increasingly providing telehealth care to older adults despite a lack of comprehensive guidance on age-friendly implementation and practice.

.- The reach of telehealth for older adults remains limited due to several factors, including existing or perceived challenges around physical and cognitive limitations, and a lack of comprehensive guidance on older-adult- focused implementation.

.- This is the first comprehensive set of provider- focused telehealth principles and guidelines, developed by aging and telehealth experts, to address the specific needs of an aging population.

Sergio Ariño Blasco's insight:

Telemonitorización dirigida a personas confinados al hogar, sin acceso a transporte, problemas de movilidad, ubicacion geográfica remota...

 

Las recomendaciones del The Collaborative for Telehealth and Aging (C4TA) constituido por proveedores, expertos en geriatria, telemedicina y organizaciones defensoras de ancianos; se orienta a una atención centrada en el paciente, equitativas, accesibles, integradas y coordinadas entre personas y sistemas. .

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Admisiones en los servicios de urgencias y costes económicos relacionados con procesos susceptibles de atención ambulatoria en adultos mayores que viven en centros residenciales | Revista Clínica E...

Admisiones en los servicios de urgencias y costes económicos relacionados con procesos susceptibles de atención ambulatoria en adultos mayores que viven en centros residenciales | Revista Clínica E... | Atención Geriátrica Integrada Comunitaria (GERiCOM Next Generation Project) | Scoop.it

Las admisiones en urgencias por ACSC procedentes de entornos residenciales suponen un impacto significativo tanto en la frecuencia como en los costes. La disminución de estas enfermedades mediante la aplicación de intervenciones específicas podría redirigir los costes evitados hacia la mejora del apoyo asistencial en los entornos residenciales.

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Economic storms threaten to cast health adrift

Is anyone listening to the World Bank's Chief Economist? Many countries, says IndermitGill, are “on a path to crisis”. The poorest countries are “stuck in a trap” that threatens to “obstruct progress on many global priorities”. “Without a major course correction, the 2020s will go down as a decade of wasted opportunity.” Gill's main
concern, as outlined in a series of World Bank reports, is the paralysing amount ofdebt, exacerbated by soaring interest rates, faced by many low-income and middle-income countries (LMICs).

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Integra at Home: A flexible continuum of in‐home medical care for older adults with complex needs - Fulton - 2024 - Journal of the American Geriatrics Society - Wiley Online Library

Journal of the American Geriatrics Society (JAGS) is the go-to geriatrics journal for clinical aging research including education, clinical practice and public policy.
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July 1, 6:51 AM
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Home alone or connected: Caregiver communication and training from health providers - Howe - 2024 - Journal of the American Geriatrics Society - Wiley Online Library

Journal of the American Geriatrics Society (JAGS) is the go-to geriatrics journal for clinical aging research including education, clinical practice and public policy.
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April 25, 2:58 AM
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Falls Prevention for Older Adults | Geriatrics | JAMA | JAMA Network

Falls Prevention for Older Adults | Geriatrics | JAMA | JAMA Network | Atención Geriátrica Integrada Comunitaria (GERiCOM Next Generation Project) | Scoop.it
This article summarizes a 2022 clinical practice guideline on falls prevention and management in older adults from the World Falls Guidelines Initiative.
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April 25, 2:53 AM
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Age-Related Hearing Loss | New England Journal of Medicine

Hearing progressively declines with age, manifesting initially as difficulty understanding speech in background noise and detrimentally affecting social functioning. Strategies and technologie
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April 23, 7:18 AM
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Understanding How Older Adults Use the U.S. Health Care System: From Measurement to Meaning

In their article, Ganguli and colleagues characterized a new measure of health care utilization—“health care contact days.” The editorialists find the measure a promising new way to understand ho
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April 5, 2:49 AM
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Community based complex interventions to sustain independence in older people: systematic review and network meta-analysis | The BMJ

Community based complex interventions to sustain independence in older people: systematic review and network meta-analysis | The BMJ | Atención Geriátrica Integrada Comunitaria (GERiCOM Next Generation Project) | Scoop.it

The intervention most likely to sustain independence is individualised care planning including medicines optimisation and regular follow-up reviews resulting in multifactorial action.

 

Homecare recipients may particularly benefit from this intervention. Unexpectedly, some combinations may reduce independence. Further research is needed to investigate which combinations of interventions work best for different participants and contexts.

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Comprehensive geriatric assessment—where are we now, where do we need to be in the context of global ageing? | Age and Ageing | Oxford Academic

Comprehensive geriatric assessment—where are we now, where do we need to be in the context of global ageing? | Age and Ageing | Oxford Academic | Atención Geriátrica Integrada Comunitaria (GERiCOM Next Generation Project) | Scoop.it

Comprehensive geriatric assessment (CGA) is the cornerstone of modern geriatric medicine and the framework around which conventional and new models of care for older people are developed. Whilst there are a substantial number of reviews synthesising the evidence on patient and service outcomes from CGA, as an intervention it remains poorly described. There is a lack of detail on how a CGA plan is coordinated, delivered and followed up, especially outside of acute care. This commentary reflects on the authors’ experience of extracting data from 57 published studies on CGA.

 

 

The CGA knowledge-do gap persists with a need to draw from complex system theory and implementation science frameworks to better describe the intervention and understand the influence of the organisation and health service within which CGA is operationalised. Equally, the voice of older people, families and staff is critical in the conduct and evaluation of CGA, and how it evolves as a model to meet the growing needs of ageing populations.

Sergio Ariño Blasco's insight:

Atención al concepto inverso.

El concepto de "Do-Know Gap" no es comúnmente utilizado, pero podría entenderse como la situación en la que una persona o entidad realiza ciertas acciones (do) antes de adquirir el conocimiento necesario (know) para llevarlas a cabo de manera efectiva o adecuada.  Reflejaría una situación en la que la acción precede al conocimiento adecuado, lo que puede llevar a resultados subóptimos o incluso contraproducentes.

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Comprehensive Geriatric Assessment for community‐dwelling, high‐risk, frail, older people - Briggs, R - 2022 | Cochrane Library

Comprehensive Geriatric Assessment for community‐dwelling, high‐risk, frail, older people - Briggs, R - 2022 | Cochrane Library | Atención Geriátrica Integrada Comunitaria (GERiCOM Next Generation Project) | Scoop.it

Comprehensive Geriatric Assessment (CGA) is a multidimensional interdisciplinary diagnostic process focused on determining an older person's medical, psychological and functional capability in order to develop a co‐ordinated and integrated care plan. CGA is not limited simply to assessment, but also directs a holistic management plan for older people, which leads to tangible interventions.

 

While there is established evidence that CGA reduces the likelihood of death and disability in acutely unwell older people, the effectiveness of CGA for community‐dwelling, frail, older people at risk of poor health outcomes is less clear.

 

CGA had no impact on death or nursing home admission.

There is low‐certainty evidence that community‐dwelling, frail, older people who undergo CGA may have a reduced risk of unplanned hospital admission.

 

Further studies examining the effect of CGA on emergency department visits and change in function and quality of life using standardised assessments are required.

 

Sergio Ariño Blasco's insight:

Necesidad de profundizar en el conocimiento sobre la efectividad de la intervención. Las variables resultado estudiadas…

 

Primary outcomes: Death, Nursing home admission, Unplanned hospital admission, Emergency department visits, Serious adverse events.

Secondary outcomes: Change in function, Quality of life (QoL), Resource use.

 

A considerar nuevas variables resultado (PROMs y PREMs).

 

 
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Comprehensive Geriatric Hospital at Home: Adaptation to Referral and Case-Mix Changes During the COVID-19 Pandemic

Comprehensive Geriatric Hospital at Home: Adaptation to Referral and Case-Mix Changes During the COVID-19 Pandemic | Atención Geriátrica Integrada Comunitaria (GERiCOM Next Generation Project) | Scoop.it

To describe the evolution of a Hospital at Home (HAH) based on comprehensive geriatric assessment (CGA), including its adaptability to changing case-mixes and pathways during
the COVID-19 pandemic.

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frailty index based on laboratory test data as a tool to investigate the impact of frailty on health outcomes: a systematic review and meta-analysis | Age and Ageing | Oxford Academic

frailty index based on laboratory test data as a tool to investigate the impact of frailty on health outcomes: a systematic review and meta-analysis | Age and Ageing | Oxford Academic | Atención Geriátrica Integrada Comunitaria (GERiCOM Next Generation Project) | Scoop.it

This systematic review and meta-analysis suggest that FI-Labs, made of diverse deficits, predict mortality and other adverse health outcomes in a variety of populations. FI-Lab scores did not show a consistent difference between sexes. This does not align with what is found with clinical FIs, which typically find females to be frailer [56].

 

Future research utilising an FI-Lab may benefit from investigating the relationship between frailty in younger populations and the subsequent health status changes. Additionally, there is emerging evidence that a more granular approach to health variable categorisation (i.e. a non-binary quantile approach) using an FI-Lab improves the model’s accuracy [46] relative to dichotomizing variables. Both avenues deserve further attention.

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Validated frailty measures using electronic primary care records: a review of diagnostic test accuracy | Age and Ageing | Oxford Academic

Validated frailty measures using electronic primary care records: a review of diagnostic test accuracy | Age and Ageing | Oxford Academic | Atención Geriátrica Integrada Comunitaria (GERiCOM Next Generation Project) | Scoop.it

eFI is the best-performing VEFM; however, based on our analysis of an average UK GP practice, it would return a high number of false-positive results. In conclusion, existing electronic frailty tools may not be appropriate for primary care-based population screening.

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Wearable Digital Health Technologies for Monitoring in Cardiovascular Medicine | NEJM

Wearable Technologies in Cardiovascular Medicine This article reviews the use of digital wearable technologies for monitoring of three common cardiovascular conditions: hypertension, hear
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