Kanninen Jonna Carita, Holm Anu, Koivisto Anna-Liisa, Hietasalo Pauliina, Heikkilä Anna-Maija, Kunvik Susanna, Bergman Jussi, Airaksinen Marja, Puustinen Juha
Faculty of Technology, Satakunta University of Applied Sciences, Pori, Finland.
Clinical Pharmacy Group, Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland.
JMIR Res Protoc. 2023 Oct 3;12:e48753. doi: 10.2196/48753.
In Finland, at least 1 in 4 residents will be >75 years of age in 2030. The national aging policy has emphasized the need to improve supportive services to enable older people to live in their own homes for as long as possible.
This study aimed to develop a preventive health screening procedure for home-dwelling older adults aged 75 years to enable the use of clinical patient data for purposes of strategic planning of supportive services in primary care.
The action research method was applied to develop the health screening procedure with selected validated health measures in cooperation with the local practicing interprofessional health care teams from 10 primary care centers in the Social Security Center of Pori, Western Finland (99,485 residents, n=11,938, 12% of them >75 years). The selection of evidence-based validated health measures was based on the national guide to screen factors increasing fall risk and the national functioning measures database. The cut-off points of the selected health measures and laboratory tests were determined in consecutive consensus meetings with the local primary care physicians, with decisions based on internationally validated measures, national current care guidelines, and local policies in clinical practice.
The health screening procedure for 75-year-old residents comprised 30 measures divided into three categories: (1) validated self-assessments (9 measures), (2) nurse-conducted screenings (14 measures), and (3) laboratory tests (7 measures). The procedure development process comprised the following steps: (1) inventory and selection of the validated health measures and laboratory tests, (2) training of practical nurses to perform screenings for the segment of 75-year-old residents and to guide them to possible further medical actions, (3) creation of research data from clinical patient data for secondary use purposes, (4) secondary data analysis, and (5) consensus meeting after the pilot test of the health screening procedure for 75-year-old residents procedure in 2019 based on the experiences of health care professionals and collected research data.
The developed preventive health screening procedure for 75-year-old residents enables the use of clinical patient data for purposes of strategic planning of supportive services in primary care if the potential bias by a low participation rate is controlled.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/48753.
在芬兰，到2030年至少四分之一的居民年龄将超过75岁。国家老龄政策强调需要改善支持性服务，以使老年人能够尽可能长时间地居家生活。
本研究旨在为75岁居家老年人制定一项预防性健康筛查程序，以便将临床患者数据用于基层医疗支持性服务的战略规划。
采用行动研究法，与芬兰西部波里社会保障中心10个基层医疗中心的当地跨专业医疗团队合作，运用选定的经过验证的健康指标制定健康筛查程序（该中心有99485名居民，其中11938名年龄超过75岁，占12%）。基于国家跌倒风险增加因素筛查指南和国家功能指标数据库选择循证验证的健康指标。在与当地基层医疗医生连续召开的共识会议上确定所选健康指标和实验室检查的临界值，决策依据国际验证指标、国家现行护理指南和临床实践中的当地政策。
针对75岁居民的健康筛查程序包括30项指标，分为三类：（1）经过验证的自我评估（9项），（2）护士进行的筛查（14项），（3）实验室检查（7项）。程序制定过程包括以下步骤：（1）清点和选择经过验证的健康指标和实验室检查，（2）培训执业护士对75岁居民进行筛查，并指导他们采取可能的进一步医疗行动，（3）从临床患者数据中创建研究数据以供二次使用，（4）二次数据分析，（5）根据医疗专业人员的经验和收集到的研究数据，在2019年对75岁居民健康筛查程序进行试点测试后召开共识会议。
如果能控制低参与率带来的潜在偏差，为75岁居民制定的预防性健康筛查程序可将临床患者数据用于基层医疗支持性服务的战略规划。
国际注册报告识别号（IRRID）：DERR1-10.2196/48753
