爱尔兰面临衰弱风险或患有衰弱症的老年人社区专家团队（CST-OP）：一项针对社区居住老年人综合护理新模式的前瞻性队列研究

Community Specialist Teams for Older Persons (CST-OP) at risk of, or living with frailty in Ireland: a prospective cohort study of a new model of integrated care for community dwelling older adults.

作者信息

Hayes Christina, Whiston Aoife, Fitzgerald Christine, Devlin Collette, Condon Brian, Manning Molly, Leahy Aoife, Robinson Katie, Galvin Rose

机构信息

School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Castletroy, Limerick, Ireland.

Department of Psychology, University of Limerick, Castletroy, Limerick, Ireland.

出版信息

BMC Prim Care. 2025 Jun 5;26(1):193. doi: 10.1186/s12875-025-02895-x.

DOI:10.1186/s12875-025-02895-x

PMID:40474059

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12139166/

Abstract

BACKGROUND

This study explored the clinical and process outcomes of older adults at risk of or living with frailty who received an interdisciplinary Comprehensive Geriatric Assessment (CGA) in the community.

METHODS

This prospective cohort study recruited older adults aged ≥ 75 who were screened for frailty and referred to one of three CST-OP hubs in the Mid-West of Ireland by their GP. Follow-up assessments were conducted via telephone by an independent assessor at 30- and 180-days. The primary outcome was functional status. Secondary outcomes included primary healthcare use, secondary healthcare use, nursing home admission, health-related quality of life (HRQoL), patient satisfaction and mortality.

RESULTS

A total of 303 participants (mean age = 83.2 years) were recruited. Incidence of 30- and 180-day functional decline was 26.4% and 33.7% respectively. The majority of older adults who availed of community-based CGA maintained functional independence up to 6-months post index visit. At 30-days, the mortality rate was 1.0%, Emergency Department (ED) presentation 6.9%, hospitalisation 6.6% and nursing home admission 4.0%. HRQoL significantly improved at 30- and 180-days. There was a significant improvement in HRQoL, F(2,542) = 13.8, p < 0.001, η = 0.5. The presence of frailty was a significant predictor of adverse outcomes.

CONCLUSION

Community-based CGA results in favorable health outcomes including HRQoL among community-dwelling older adults. Community-based CGA may also mitigate against potentially avoidable ED presentations and hospitalisations. Use of the Clinical Frailty Scale is recommended to predict the risk of functional decline, increased rates of mortality, NH admission, hospitalisation or ED presentation at 30- and 180-days among community-dwelling older adults.

TRIAL REGISTRATION

The study protocol was prospectively registered on Clinicaltrials.gov (NCT05527223). Registered January 09, 2022. https://clinicaltrials.gov ..

摘要

背景

本研究探讨了有衰弱风险或患有衰弱症的老年人在社区接受多学科综合老年评估（CGA）后的临床和过程结果。

方法

这项前瞻性队列研究招募了年龄≥75岁的老年人，这些老年人接受了衰弱筛查，并由其全科医生转介至爱尔兰中西部的三个CST-OP中心之一。独立评估员在30天和180天时通过电话进行随访评估。主要结局是功能状态。次要结局包括初级医疗保健使用情况、二级医疗保健使用情况、养老院入住情况、健康相关生活质量（HRQoL）、患者满意度和死亡率。

结果

共招募了303名参与者（平均年龄=83.2岁）。30天和180天功能下降的发生率分别为26.4%和33.7%。大多数接受社区CGA的老年人在索引访视后6个月内保持功能独立。在30天时，死亡率为1.0%，急诊就诊率为6.9%，住院率为6.6%，养老院入住率为4.0%。HRQoL在30天和180天时显著改善。HRQoL有显著改善，F(2,542)=13.8，p<0.001，η=0.5。衰弱的存在是不良结局的重要预测因素。