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改善印度老年人的健康状况:基于新型综合老年评估干预措施的有效性和可实施性。

Improving health outcomes among older adults in India: effectiveness and implementability of a novel comprehensive geriatric assessment based intervention.

作者信息

Kshatri Jaya Singh, Shenkin Susan, Mercer Stewart, Weller David, Palo Subrata Kumar, Pati Sandipana, Janssen Daisy, Pati Sanghamitra

机构信息

Regional Medical Research Centre, Indian Council of Medical Research, Bhubaneswar, Odisha, 751023, India.

Usher Institute, The University of Edinburgh, Edinburgh, Scotland, EH89AG, UK.

出版信息

Wellcome Open Res. 2024 Nov 8;8:414. doi: 10.12688/wellcomeopenres.19796.3. eCollection 2023.

Abstract

BACKGROUND

There is significant evidence on the benefits of comprehensive assessment in older adults. But this evidence is primarily from western countries and in secondary care settings. National policies in India recognize this need and envision community-based screening and facility-based assessment programs integrated into the care pathways for the elderly. However, this is yet to translate into specific interventions, primarily due to lack of complex interventions necessary and evidence of their effectiveness. This study aims to design and pilot an integrated (Community + Facility) Elderly Health Status Assessment and Screening (EHSAS) intervention to improve health outcomes of older adults and assess its feasibility for implementation in Indian rural settings.

METHODS

We propose a hybrid design where we will build the complex intervention, develop and validate the tools needed, pilot it using an exploratory cluster randomized trial and evaluate its implementatbility using the Exploration-Preparation-Implementation-Sustainment (EPIS) framework.

CONCLUSIONS

This study will fill critical gaps in evidence regarding the effectiveness of geriatric screening and assessment in community and primary care settings in low-middle income countries and provide validated tools and implementation models for adoption into national programs.

REGISTRATION

CTRI/2023/07/055661.

摘要

背景

有大量证据表明综合评估对老年人有益。但这些证据主要来自西方国家且是在二级医疗环境中。印度的国家政策认识到了这一需求,并设想将基于社区的筛查和基于机构的评估项目纳入老年人的护理路径。然而,这尚未转化为具体干预措施,主要是因为缺乏必要的复杂干预措施及其有效性的证据。本研究旨在设计并试点一项综合(社区 + 机构)老年人健康状况评估与筛查(EHSAS)干预措施,以改善老年人的健康结局,并评估其在印度农村地区实施的可行性。

方法

我们提出一种混合设计,即构建复杂干预措施,开发并验证所需工具,通过探索性整群随机试验进行试点,并使用探索 - 准备 - 实施 - 维持(EPIS)框架评估其可实施性。

结论

本研究将填补中低收入国家社区和初级医疗环境中老年筛查和评估有效性方面的关键证据空白,并提供经过验证的工具和实施模式,以供纳入国家项目。

注册信息

CTRI/2023/07/055661 。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e49/11565130/c55367a0a1f8/wellcomeopenres-8-25795-g0000.jpg

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