- 期刊
The Effectiveness of an Outpatient Personalized Multidisciplinary Intervention Model, Guided by Comprehensive Geriatric Assessment, for Pre-Frail and Frail Elderly
摘要
Background: Our study evaluates the efficacy of an outpatient personalized multidisciplinary intervention model guided by comprehensive geriatric assessment (CGA), for pre-frail and frail elderly. Methods: A single-arm self-controlled study was conducted at the outpatient departments (OPD) of a medical center in Taiwan. Subjects received personalized multidisciplinary intervention, including physical therapy, psychotherapy, a nutritional consultation, precise medicine, and social resource linkage, as determined by the results of their CGAs. After 3 months of interventions, change in the proportions of the frail status (frail, pre-frail and robust), functional scores, depressive status, cognition, nutritional status, percentage of inappropriate medication used and social resource usage were analyzed. A logistic regression model was applied to determine the predictive factors associated with an improvement in frail severity. Results: A significant improvement in frail status was found (proportion of frail: 44.5% versus 23.1%, p ＜ 0.001). Physical function, depressive and nutritional status were also significantly improved. 18.5% of participants used inappropriate medications, with benzodiazepine hypnotics the most common (40.9%). 24.2% of subjects were successfully linked to social resources. The presence of the frail phenotypes exhaustion was significantly associated with an improvement in frail severity (odds ratio (OR) = 2.77, 95% confidence interval (CI) = 1.15-6.66, p = 0.023). There was a significant dose response relationship between the improvement of frail status and physical training times (proportion of improved frail status: 23.7%, 40.5% and 47.9% for 0, 1-3, and 4-6 times of physical training, p = 0.03). Conclusion: The reported CGA-based, personalized multidisciplinary intervention model was effective at improving frail severity among pre-frail and frail elderly in OPDs.
延伸閱讀
- Richter, J., Schwarz, M., & Bauer, B. (2008). Personality Characteristics Determine Health-Related Quality of Life as an Outcome Indicator of Geriatric Inpatient Rehabilitation. Current Gerontology and Geriatrics Research, 2008(), 2-9. https://doi.org/10.1155/2008/474618
- Chang, C. J., Lin, C. H., Li, T. P., Hsu, C. S., Tsai, H. Y., & Liu, T. C. (2023). Short Term Structured, Multimodal, Interdisciplinary, Home-Based, Self-Help Program is Effective in Improving Frailty Status among Elderly T2DM Patients. International Journal of Gerontology, 17(1), 59-64. https://doi.org/10.6890/IJGE.202301_17(1).0012
- Kawryshanker, S., Raymond, W., Ingram, K., & Inderjeeth, C. A. (2014). Effect of Frailty on Functional Gain, Resource Utilisation, and Discharge Destination: An Observational Prospective Study in a GEM Ward. Current Gerontology and Geriatrics Research, (2014), b1-8. https://doi.org/10.1155/2014/357857
- 高佳霙、丁紀台、葉明珍、張彩秀（2008）。The Effectiveness of Comprehensive Care Programs at Improving Self-care and Quality of Life and Reducing Rehospitalization in Patients with Congestive Heart Failure。實證護理，4(3)，233-242。https://doi.org/10.6225/JEBN.4.3.233
- 鄭琪霖（2021）。How to Use Comprehensive Geriatric Assessment to Improve the Quality of Care for Elderly Patients Hospitalized with Cellulitis。台灣老年醫學暨老年學會雜誌，16(4)，345-352。https://doi.org/10.29461/TGGa.202111_16(4).0007