Department of Public Health and Primary Care, Gerontology and Geriatrics, KU Leuven, Leuven, Belgium.
Department of Public Health, Nursing Science, University of Basel, Basel, Switzerland.
Eur Geriatr Med. 2021 Feb;12(1):175-184. doi: 10.1007/s41999-020-00397-w. Epub 2020 Sep 25.
Inpatient geriatric consultation teams (IGCTs) provide recommendations for the care of older patients hospitalized on non-geriatric wards based on comprehensive geriatric assessment. The lack of adherence to their recommendations hinders the potential impact of IGCTs. We evaluated the adherence to IGCT recommendations and determined which team and recommendation characteristics are related to higher adherence rates.
Multicenter observational study in older adults aged ≥ 75 years admitted to an acute non-geriatric ward. Demographic and adherence data were collected for 30 consecutive patients. A cross-sectional survey mapped team and organizational characteristics of the participating IGCTs.
Analyses were conducted in 278 patients (51.4% male, mean age 82.5 years, and median length of stay 10 days). There was a median number of 3 recommendations (range 1-13) per patient. The overall adherence rate was 69.7%. Recommendations related to 'social status' (82.4%) and 'functional status/mobility' (73.3%) were best adhered to. Recommendations related to 'medication' (53.2%) and 'nutritional status' (59.1%) were least adhered to. Adherence rates increased if recommendations were given to allied health professionals (OR = 6.37, 95% CI = 1.15-35.35) or by more experienced IGCTs (OR = 1.34, 95% CI = 1.04-1.72) and decreased when more recommendations were given (OR = 0.51, 95% CI = 0.33-0.80).
Adherence rate to IGCT recommendations increased if given to allied health professionals or by more experienced IGCTs and when fewer recommendations were given. Study replication in an international multicenter study with a larger number of centers and evaluating the quality of the recommendations is suggested.
住院老年咨询团队（IGCT）根据综合老年评估为非老年病房住院的老年患者提供护理建议。不遵守这些建议会阻碍 IGCT 的潜在影响。我们评估了 IGCT 建议的遵守情况，并确定了哪些团队和建议特征与更高的遵守率相关。
对年龄≥75 岁的老年患者进行了一项多中心观察性研究，这些患者被收入急性非老年病房。收集了 30 名连续患者的人口统计学和遵守数据。一项横断面调查绘制了参与 IGCT 的团队和组织特征图。
对 278 名患者（51.4%为男性，平均年龄 82.5 岁，中位住院时间为 10 天）进行了分析。每位患者的建议中位数为 3 项（范围 1-13）。总体遵守率为 69.7%。与“社会地位”（82.4%）和“功能状态/活动能力”（73.3%）相关的建议得到了最好的遵守。与“药物”（53.2%）和“营养状况”（59.1%）相关的建议得到了最差的遵守。如果建议是向辅助卫生专业人员提供的（OR=6.37，95%CI=1.15-35.35）或由经验更丰富的 IGCT 提供的（OR=1.34，95%CI=1.04-1.72），则遵守率会增加，如果提供的建议较少（OR=0.51，95%CI=0.33-0.80），则遵守率会降低。
如果向辅助卫生专业人员或经验更丰富的 IGCT 提供建议，或者提供的建议较少，则 IGCT 建议的遵守率会增加。建议在国际多中心研究中进行研究复制，纳入更多中心并评估建议的质量。
