Abstract / Description of output
Background
Evidence to support comprehensive geriatric assessment (CGA) in primary care for frail older people is limited.
Aim
To evaluate a general practitioner (GP) led adapted CGA quality improvement project
Design and 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 LWA, analysed by thematic analysis.
Results
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 (59%) stated a preference for face-to-face consultation. For the 41% who preferred remote LWA, most (33%) preferred telephone to video consultation (8%). Problems in remote consultations related to technical issues (video), poor vision (video) or deafness (telephone/ 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 due to the LWA and whether it was an efficient use of GPs’ time.
Conclusions
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.
Evidence to support comprehensive geriatric assessment (CGA) in primary care for frail older people is limited.
Aim
To evaluate a general practitioner (GP) led adapted CGA quality improvement project
Design and 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 LWA, analysed by thematic analysis.
Results
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 (59%) stated a preference for face-to-face consultation. For the 41% who preferred remote LWA, most (33%) preferred telephone to video consultation (8%). Problems in remote consultations related to technical issues (video), poor vision (video) or deafness (telephone/ 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 due to the LWA and whether it was an efficient use of GPs’ time.
Conclusions
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.
| Original language | English |
|---|---|
| Journal | British Journal of General Practice Open (BJGP Open) |
| Early online date | 23 Dec 2022 |
| DOIs | |
| Publication status | E-pub ahead of print - 23 Dec 2022 |