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“这就是魔法”——一种适用于全科医疗的可管理的老年评估方法的开发。

"It's MAGIC"--development of a manageable geriatric assessment for general practice use.

作者信息

Barkhausen Tanja, Junius-Walker Ulrike, Hummers-Pradier Eva, Mueller Christiane A, Theile Gudrun

机构信息

Institute for General Practice, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany.

Department of General Practice, University Medical Centre Goettingen, Humboldtallee 38, 37073, Goettingen, Germany.

出版信息

BMC Fam Pract. 2015 Jan 22;16:4. doi: 10.1186/s12875-014-0215-4.

Abstract

BACKGROUND

Geriatric assessments are established tools in institutional care since they enable standardized detection of relevant age-related disorders. Geriatric assessments could also be helpful in general practice. However, they are infrequently used in this setting, mainly due to their lengthy administration. The aim of the study was the development of a "manageable geriatric assessment--MAGIC", specially tailored to the requirements of daily primary care.

METHODS

MAGIC was developed based on the comprehensive Standardized Assessment for Elderly People in Primary Care (STEP), using four different methodological approaches: We relied on A) the results of the PRISCUS study by assessing the prevalence of health problems uncovered by STEP, the importance of the respective problems rated by patients and general practitioners, as well as the treatment procedures initiated subsequently to the assessment. Moreover, we included findings of B) a literature analysis C) a review of the STEP assessment by experienced general practitioners and D) focus groups with general practitioners.

RESULTS

The newly created MAGIC assessment consists of 9 items and covers typical geriatric health problems and syndromes: function, falls, incontinence, cognitive impairment, impaired ears and eyes, vaccine coverage, emotional instability and isolation.

CONCLUSIONS

MAGIC promises to be a helpful screening instrument in primary care consultations involving elderly multimorbid patients. Applicable within a minimum of time it still covers health problems highly relevant with regard to a potential loss of autonomy. Feasibility will be tested in the context of a large, still ongoing randomized controlled trial on "reduction of potentially inadequate medication in elderly patients" (RIME study; DRKS-ID: DRKS00003610) in general practice.

摘要

背景

老年评估是机构护理中的既定工具,因为它们能够对相关的年龄相关疾病进行标准化检测。老年评估在全科医疗中也可能会有所帮助。然而,它们在这种情况下很少使用,主要是因为其管理过程冗长。本研究的目的是开发一种“可管理的老年评估——MAGIC”,专门针对日常初级保健的需求进行定制。

方法

MAGIC是在初级保健中老年人综合标准化评估(STEP)的基础上开发的,采用了四种不同的方法:我们依赖于A)PRISCUS研究的结果,评估STEP发现的健康问题的患病率、患者和全科医生对各自问题的重视程度,以及评估后启动的治疗程序。此外,我们纳入了B)文献分析、C)经验丰富的全科医生对STEP评估的审查以及D)与全科医生进行的焦点小组的研究结果。

结果

新创建的MAGIC评估包括9个项目,涵盖典型的老年健康问题和综合征:功能、跌倒、失禁、认知障碍、耳眼功能受损、疫苗接种率、情绪不稳定和孤独感。

结论

MAGIC有望成为涉及老年多病患者的初级保健咨询中的一种有用筛查工具。它在最短时间内适用,同时仍涵盖与潜在自主性丧失高度相关的健康问题。可行性将在一项大型、仍在进行的关于“减少老年患者潜在不适当用药”的随机对照试验(RIME研究;DRKS-ID:DRKS00003610)的背景下在全科医疗中进行测试。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9da/4320637/31cb8c1fb673/12875_2014_215_Fig1_HTML.jpg

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