Geriatric Assessment, Nursing Home Resident
Conditions
Brief summary
Nursing home (NH) residents have complex healthcare needs. Barriers to collaboration hinder the delivery of high-quality care in nursing homes. To bridge the gap between hospital-based and NH-based care, various innovative approaches have been proposed, including geriatric mobile teams. In Belgium, geriatric expertise has long been confined to hospital settings. Until recently, no specific organization existed for outpatient geriatric assessment, particularly for NH residents. In April 2024, the National Institute for Health and Disability Insurance (INAMI) introduced a new reimbursement code for geriatric consultations in NHs, promoting the development of extramural geriatric activities. However, evidence on the effectiveness of mobile geriatric teams remains limited, particularly regarding hospitalization prevention. The geriatrics department of CHU UCL Namur is implementing a one-year pilot project involving a mobile team composed of a geriatrician and a nurse to conduct geriatric assessments in the three nursing homes. This non-randomized pilot project aims to establish a new standard of care for residents selected by their general practitioner, leveraging the new reimbursement code. The project is accompanied by a clinical study assessing the feasibility, effectiveness, and acceptability of this intervention. Prospectively collected data will also help define key indicators for a future large-scale study focused on cost-effectiveness.
Interventions
OTHERGeriatric assessment
The tertiary hospital's geriatrics department is implementing a one-year mobile team composed of a geriatrician and a nurse to conduct geriatric assessments (Anamnesis and heteroanamnesis - Clinical examination - Medication review - Proposed management plan provided to the general practionner, who independently decides which recommendations to implement) in three nursing homes. This non-randomized pilot project aims to establish a new standard of care for residents selected by their primary care physician. The project is accompanied by a clinical study designed to assess the feasibility, effectiveness, and acceptability of this intervention. Prospectively collected data will also help define key indicators for a future large-scale study focusing on cost-effectiveness.
Sponsors
CHU UCL Namur
Université Catholique de Louvain
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
70 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients aged over 70 years * Presenting with one or more of the following conditions: * Difficulties in establishing an advance care planning * Medical complexity (multiple specialists, repeated hospitalizations) * Polypharmacy * Recurrent falls * Unmanageable behavioral disorders * Weight loss * Memory impairment
Exclusion criteria
* Patients with an unstable medical condition requiring urgent care * Patients under 70 years old * Patients whose condition requires examinations or treatments available only in a hospital setting
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Feasability | Immediately after the initial consultation, with follow-up assessments at 3, 6, 9, and up to 12 months post-inclusion. |
Secondary
| Measure | Time frame |
|---|---|
| Acceptability | Immediately after the initial consultation, with follow-up assessments at 3, 6, 9, and up to 12 months post-inclusion |
| Determine the outcomes for a future full evaluation study. | Immediately after the initial consultation, with follow-up assessments at 3, 6, 9, and up to 12 months post-inclusion |
Countries
Belgium
Contacts
Primary ContactMarie de Saint-Hubert
Outcome results
None listed