Bitas Christiana, Jones Sian, Singh Harjot Kaur, Ramirez Mildred, Siegler Eugenia, Glesby Marshall
1 Department of Obstetrics and Gynecology, Tufts University Medical Center, Boston, MA, USA.
2 Division of Infectious Diseases, Weill Cornell Medicine, New York, NY, USA.
J Int Assoc Provid AIDS Care. 2019 Jan-Dec;18:2325958218821656. doi: 10.1177/2325958218821656.
This retrospective cohort study sought to assess the effectiveness of comprehensive geriatric assessment (CGA) for older patients at an HIV clinic in a large US city. We systematically reviewed medical records of all patients who underwent CGA from June 2013 to July 2017. In addition, physicians and social workers completed an anonymous survey about the impact of CGA on their patients. For the 76 patients (median age 67.2; Q1, Q3 = 60.9, 72.6) seen by geriatricians at the clinic, there were 184 recommendations, 54 instances of counseling, and 11 direct actions. Overall adherence to recommendations was 32.8%, 34.9% for patient-directed, and 31.7% for provider-directed recommendations. No demographic or CGA variables were associated with adherence. Despite this lack of adherence, surveyed providers reported that they usually or always followed recommendations; the most frequently cited barrier to implementation was lack of feasibility. Further research will be needed to determine how CGA can improve outcomes for this population.
这项回顾性队列研究旨在评估在美国一个大城市的一家艾滋病诊所对老年患者进行综合老年评估（CGA）的效果。我们系统地回顾了2013年6月至2017年7月期间所有接受CGA的患者的病历。此外，医生和社会工作者完成了一项关于CGA对其患者影响的匿名调查。对于该诊所老年病医生诊治的76名患者（中位年龄67.2岁；第一四分位数、第三四分位数分别为60.9岁、72.6岁），共提出了184条建议、进行了54次咨询以及采取了11项直接行动。总体建议依从率为32.8%，患者主导的建议依从率为34.9%，提供者主导的建议依从率为31.7%。没有人口统计学或CGA变量与依从性相关。尽管存在这种不依从情况，但接受调查的提供者报告称他们通常或总是遵循建议；最常被提及的实施障碍是缺乏可行性。需要进一步研究以确定CGA如何改善该人群的治疗结果。
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