Fernández-Salido Mirian, Alhambra-Borrás Tamara, Garcés-Ferrer Jorge
Research Institute on Social Welfare Policy (POLIBIENESTAR), Universitat de València, 46022 Valencia, Spain.
Healthcare (Basel). 2024 Sep 3;12(17):1754. doi: 10.3390/healthcare12171754.
Frailty is a common condition in older adults that negatively impacts health and quality of life. This study evaluated a comprehensive, personalised, and coordinated intervention under the value-based care approach to address frailty's multidimensional nature in older people in the primary care setting. It employed a pre-post randomised controlled design involving 242 frail individuals aged over 65 years living in the community in Valencia (Spain) between 2021 and 2023. Assessments were conducted at baseline, 12 months (immediately post-intervention), and 18 months. The intervention included a personalised care plan supported by technology, with monthly motivational follow-ups and plan updates by health professionals and participants. Outcomes were measured using an assessment questionnaire that included the International Consortium for Health Outcomes Measurement dataset for the older population: physical health, physical functioning, general mental health, satisfaction with social activities and relationships, ability to carry out usual social roles and activities, pain, general quality of life, loneliness, physical frailty, psychological frailty, and social frailty. The study found significant improvements in physical frailty, quality of life, reduced health resource use and hospitalisations and lower levels of pain and depression/anxiety compared to baseline. The findings suggest further research into value-based care approaches, emphasizing the development and activation of personalised, comprehensive programs for older individuals with frailty.
衰弱是老年人的一种常见状况,会对健康和生活质量产生负面影响。本研究评估了在基于价值的照护方法下的一项全面、个性化且协调一致的干预措施,以应对初级保健环境中老年人衰弱的多维度性质。该研究采用了前后随机对照设计,涉及2021年至2023年间居住在西班牙巴伦西亚社区的242名65岁以上的衰弱个体。在基线、12个月(干预后立即)和18个月时进行评估。干预措施包括一个由技术支持的个性化护理计划,由健康专业人员和参与者每月进行激励性随访并更新计划。使用一份评估问卷来衡量结果,该问卷包括针对老年人群体的国际健康结果测量联盟数据集:身体健康、身体功能、总体心理健康、对社交活动和人际关系的满意度、履行日常社会角色和活动的能力、疼痛、总体生活质量、孤独感、身体衰弱、心理衰弱和社会衰弱。研究发现,与基线相比,身体衰弱、生活质量有显著改善,健康资源使用和住院次数减少,疼痛和抑郁/焦虑水平降低。研究结果表明,需要进一步研究基于价值的照护方法,强调为衰弱的老年人制定和启动个性化、全面的项目。