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01-10-2013

Bewijs voor effectiviteit van Comprehensive Geriatric Assessment in de thuissituatie nog mager: een literatuurreview

Auteurs: E. C. M. van Mulligen-van de Belt, M. Smalbrugge, M. F. I. A. Depla

Gepubliceerd in: Tijdschrift voor Gerontologie en Geriatrie | Uitgave 5/2013

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Samenvatting

Achtergrond

De meeste ouderen vinden het belangrijk zo lang mogelijk zelfstandig te blijven functioneren. Gerichte opsporing en behandeling van factoren die de functionele zelfstandigheid bedreigen, middels een comprehensive geriatric assessment (CGA), kan het zelfstandig functioneren mogelijk bevorderen. Dit artikel doet verslag van een literatuurstudie naar het effect van comprehensive geriatric assessment in de thuissituatie.

Methode

In Pubmed (1977–2012) is gezocht naar RCT’s die de effectiviteit van multidisciplinaire, multidimensionele CGA bij ouderen in de thuissituatie onderzocht hebben. Er werden data geëxtraheerd over effectiviteit, kosten en factoren die het effect van het CGA positief of negatief hebben beïnvloed.

Resultaten

Negen RCT’s werden geïncludeerd. Op één studie na was de kwaliteit matig tot goed. In drie van de zes studies naar functionele status en in twee van de vier studies naar kwaliteit van leven werd een positief effect gevonden. Geen effect werd gevonden op het aantal ziekenhuisopnames en verpleeghuisopnames of op mortaliteit. De meeste studies lieten een stijging zien van de totale gezondheidszorgkosten.

Conclusie

CGA thuis heeft een beperkt gunstig effect op functionele status en kwaliteit van leven. Er zijn aanwijzingen dat CGA thuis het meeste effect heeft bij relatief goed functionerende ouderen.
Literatuur
1.
go back to reference Ploeg ES van der. Care for vulnerable older persons: need, utilization and appropriateness (proefschrift).Rotterdam: Erasmus Universiteit Rotterdam, 2009 Ploeg ES van der. Care for vulnerable older persons: need, utilization and appropriateness (proefschrift).Rotterdam: Erasmus Universiteit Rotterdam, 2009
2.
go back to reference NVVA Beleidsplan 2006-2012. De algemeen geriater thuis in de ouderenzorg. Utrecht, NVVA, 2007 NVVA Beleidsplan 2006-2012. De algemeen geriater thuis in de ouderenzorg. Utrecht, NVVA, 2007
3.
go back to reference Gezondheidsraad. Ouderdom komt met gebreken. Den Haag: gezondheidsraad, 2008; publicatienummer 2008-01 Gezondheidsraad. Ouderdom komt met gebreken. Den Haag: gezondheidsraad, 2008; publicatienummer 2008-01
4.
go back to reference KNMG. Sterke medische zorg voor kwetsbare ouderen, KNMG, maart 2010 KNMG. Sterke medische zorg voor kwetsbare ouderen, KNMG, maart 2010
5.
go back to reference De Groot AJ. Zorgadvies aan huis: de werkwijze van een ouderenteam nader bekeken. Tijdschrift voor ouderengeneeskunde 2010;6:223-7. De Groot AJ. Zorgadvies aan huis: de werkwijze van een ouderenteam nader bekeken. Tijdschrift voor ouderengeneeskunde 2010;6:223-7.
6.
go back to reference Brown SD et al. National Institutes of Health Consensus Development Conference Statement: Geriatric assessment methods for clinical decision-making. J Am Geriatr Soc 1988;36:342-7 Brown SD et al. National Institutes of Health Consensus Development Conference Statement: Geriatric assessment methods for clinical decision-making. J Am Geriatr Soc 1988;36:342-7
7.
go back to reference Nederlandse Vereniging voor Klinische Geriatrie (NVKG). Richtlijn’Comprehensive geriatric assessment’. Utrecht: NVKG; 2010. Nederlandse Vereniging voor Klinische Geriatrie (NVKG). Richtlijn’Comprehensive geriatric assessment’. Utrecht: NVKG; 2010.
8.
go back to reference Molag ML, Golüke-Willemse GAM, Arends AJ, van Barneveld TA. De richtlijn ‘Comprehensive geriatric assessment’. Ned Tijdschr Geneeskd. 2011;155:A3815 Molag ML, Golüke-Willemse GAM, Arends AJ, van Barneveld TA. De richtlijn ‘Comprehensive geriatric assessment’. Ned Tijdschr Geneeskd. 2011;155:A3815
9.
go back to reference Ellis G, Whitehead MA, O’Neill D, Langhorne P, Robinson D. Comprehensive geriatric assessment for older adults admitted to hospital. [Cochrane review]. Cochrane Database Syst Rev. 2011;(7):CD006211.PubMed Ellis G, Whitehead MA, O’Neill D, Langhorne P, Robinson D. Comprehensive geriatric assessment for older adults admitted to hospital. [Cochrane review]. Cochrane Database Syst Rev. 2011;(7):CD006211.PubMed
10.
go back to reference Blauw GJ, Maier AB. Uitgebreide geriatrische assessment: nu onhaalbaar en ongewenst. Ned Tijdschr Geneeskd. 2011;155:A4010 Blauw GJ, Maier AB. Uitgebreide geriatrische assessment: nu onhaalbaar en ongewenst. Ned Tijdschr Geneeskd. 2011;155:A4010
12.
go back to reference Boorsma M, Frijters DHM, Knol DL, Ribbe ME, Nijpels G, Hout HPJ van. Effects of multidisciplinary integrated care on quality of care in residential care facilities for older people: a cluster randomised trial. CMAJ 2011;183: E724-32 Boorsma M, Frijters DHM, Knol DL, Ribbe ME, Nijpels G, Hout HPJ van. Effects of multidisciplinary integrated care on quality of care in residential care facilities for older people: a cluster randomised trial. CMAJ 2011;183: E724-32
13.
go back to reference MacNeil Vroomen JL, Boorsma M, Bosmans JE, Frijters DHM, Nijpels G, van Hout HPJ. Is it a time for change? A cost-effectiveness analysis comparing a multidisciplinary integrated care model for residential homes to usual care. PLoS ONE 7(5):e37444. doi:10.1371/journal.pone.0037444 MacNeil Vroomen JL, Boorsma M, Bosmans JE, Frijters DHM, Nijpels G, van Hout HPJ. Is it a time for change? A cost-effectiveness analysis comparing a multidisciplinary integrated care model for residential homes to usual care. PLoS ONE 7(5):e37444. doi:10.​1371/​journal.​pone.​0037444
14.
go back to reference Dalby DM, Sellors JW, Fraser FD, Fraser C, Ineveld C van, Howard M. Effect of preventive home visits by a nurse on the outcomes of frail elderly people in the community: a randomised controlled trial. CMAJ 2000;162:497-500 Dalby DM, Sellors JW, Fraser FD, Fraser C, Ineveld C van, Howard M. Effect of preventive home visits by a nurse on the outcomes of frail elderly people in the community: a randomised controlled trial. CMAJ 2000;162:497-500
15.
go back to reference Fletcher AE et al. Population-based multidimensional assessment of older people in UK general practice: a cluster-randomised factorial trial. Lancet 2004;364:1667-77PubMedCrossRef Fletcher AE et al. Population-based multidimensional assessment of older people in UK general practice: a cluster-randomised factorial trial. Lancet 2004;364:1667-77PubMedCrossRef
16.
go back to reference Melis RJF et al. A randomized study of a multidisciplinary program to intervene on geriatric syndromes in vulnerable older people who live at home (Dutch Easy Care study). J Gerontol A Biol Sci Med Sci 2008;63:283-90PubMedCrossRef Melis RJF et al. A randomized study of a multidisciplinary program to intervene on geriatric syndromes in vulnerable older people who live at home (Dutch Easy Care study). J Gerontol A Biol Sci Med Sci 2008;63:283-90PubMedCrossRef
17.
go back to reference Melis RJF et al. Cost-effectiveness of a multidisciplinary intervention model for community-dwelling frail older people. J Gerontol A Biol Sci Med Sci 2008; 63:275-82PubMedCrossRef Melis RJF et al. Cost-effectiveness of a multidisciplinary intervention model for community-dwelling frail older people. J Gerontol A Biol Sci Med Sci 2008; 63:275-82PubMedCrossRef
18.
go back to reference Monteserin R et al. Effectiveness of a geriatric intervention in primary care: a randomised clinical trial. Fam Pract 2010; 27:239-45PubMedCrossRef Monteserin R et al. Effectiveness of a geriatric intervention in primary care: a randomised clinical trial. Fam Pract 2010; 27:239-45PubMedCrossRef
19.
go back to reference Rockwood K et al. A clinimetric evaluation of specialized geriatric care for rural dwelling, frail older people. J Am Geriatr Soc 2000;48:1080-5PubMed Rockwood K et al. A clinimetric evaluation of specialized geriatric care for rural dwelling, frail older people. J Am Geriatr Soc 2000;48:1080-5PubMed
20.
go back to reference Stuck AE et al. A trial of annual in-home comprehensive geriatric assessment for elderly people living in the community. NEJM 1995;333:1184-9PubMedCrossRef Stuck AE et al. A trial of annual in-home comprehensive geriatric assessment for elderly people living in the community. NEJM 1995;333:1184-9PubMedCrossRef
21.
go back to reference Stuck AE et al. A randomized trial of in-home visits for disability prevention in community-dwelling older people at low and high risk for nursing home admission. Arch Intern Med 2000;160:977-86PubMedCrossRef Stuck AE et al. A randomized trial of in-home visits for disability prevention in community-dwelling older people at low and high risk for nursing home admission. Arch Intern Med 2000;160:977-86PubMedCrossRef
22.
go back to reference Sommers LS, Marton KI, Barbaccia JC, Randolph J. Physician, nurse and social worker collaboration in primary care for chronically ill seniors. Arch Intern Med 2000; 160:1825-33PubMedCrossRef Sommers LS, Marton KI, Barbaccia JC, Randolph J. Physician, nurse and social worker collaboration in primary care for chronically ill seniors. Arch Intern Med 2000; 160:1825-33PubMedCrossRef
23.
go back to reference Haastregt JCM van, Diederiks JPM, Rossum E van, Witte LP de, Crebolder HFJM. Effects of preventive home visits to elderly living in the community: systematic review. BMJ 2001; 320(7237):754-8 Haastregt JCM van, Diederiks JPM, Rossum E van, Witte LP de, Crebolder HFJM. Effects of preventive home visits to elderly living in the community: systematic review. BMJ 2001; 320(7237):754-8
24.
go back to reference Stuck AE, Egger M, Hammer A, Minder CE, Beck JC. Home visits to prevent nursing home admission and functional decline in elderly people: systematic review and meta-regression analysis. JAMA 2002;287: 1022-8PubMedCrossRef Stuck AE, Egger M, Hammer A, Minder CE, Beck JC. Home visits to prevent nursing home admission and functional decline in elderly people: systematic review and meta-regression analysis. JAMA 2002;287: 1022-8PubMedCrossRef
25.
go back to reference Beswick AD et al. Complex interventions to improve physical function and maintain independent living in elderly people: a systematic review and meta-analysis. Lancet 2008;371:725-35PubMedCrossRef Beswick AD et al. Complex interventions to improve physical function and maintain independent living in elderly people: a systematic review and meta-analysis. Lancet 2008;371:725-35PubMedCrossRef
26.
go back to reference Huss A, Stuck AE, Rubenstein LZ, Egger M, Clough-Gorr KM. Multidimensional preventive home visit programs for community-dwelling older adults: a systematic review and meta-analysis of randomised controlled trials. J Gerontol A Biol Sci Med Sci 2008;63:298-307PubMedCrossRef Huss A, Stuck AE, Rubenstein LZ, Egger M, Clough-Gorr KM. Multidimensional preventive home visit programs for community-dwelling older adults: a systematic review and meta-analysis of randomised controlled trials. J Gerontol A Biol Sci Med Sci 2008;63:298-307PubMedCrossRef
27.
go back to reference Stuck AE, Siu AL, Wieland GD, Adams J, Rubenstein LZ. Comprehensive geriatric assessment: a meta-analysis of controlled trials. Lancet 1993;342:1032-6PubMedCrossRef Stuck AE, Siu AL, Wieland GD, Adams J, Rubenstein LZ. Comprehensive geriatric assessment: a meta-analysis of controlled trials. Lancet 1993;342:1032-6PubMedCrossRef
28.
go back to reference Ploeg J, Feightner J, Hutchison B, Patterson C, Sigouin C, Gauld M.. Effectiveness of primary care outreach interventions aimed at older people: meta-analysis of randomized controlled trials. Can Fam Physician 2005;51:1244-5PubMed Ploeg J, Feightner J, Hutchison B, Patterson C, Sigouin C, Gauld M.. Effectiveness of primary care outreach interventions aimed at older people: meta-analysis of randomized controlled trials. Can Fam Physician 2005;51:1244-5PubMed
29.
go back to reference Bouman A, van Rossum E, Nelemans P, Kempen GIJM, Knipschild P. Effects of intensive home visiting programs for older people with poor health status: a systematic review. BMC Health Serv Res 2008;8:74PubMedCrossRef Bouman A, van Rossum E, Nelemans P, Kempen GIJM, Knipschild P. Effects of intensive home visiting programs for older people with poor health status: a systematic review. BMC Health Serv Res 2008;8:74PubMedCrossRef
30.
go back to reference Lin JS et al. Challenges in synthesizing and interpreting the evidence from a systematic review of multifactorial interventions to prevent functional decline in older adults. J Am Geriatr Soc 2012;60:2157-66PubMed Lin JS et al. Challenges in synthesizing and interpreting the evidence from a systematic review of multifactorial interventions to prevent functional decline in older adults. J Am Geriatr Soc 2012;60:2157-66PubMed
31.
go back to reference Reuben et al. Physician implementation of and patient adherence to recommendations from comprehensive geriatric assessment. Am J Med 1996;100:444-54 Reuben et al. Physician implementation of and patient adherence to recommendations from comprehensive geriatric assessment. Am J Med 1996;100:444-54
32.
go back to reference Aminzadeh F. Adherence to recommendations of community-based comprehensive geriatric assessment programs. Age Ageing 2000;29:401-7PubMedCrossRef Aminzadeh F. Adherence to recommendations of community-based comprehensive geriatric assessment programs. Age Ageing 2000;29:401-7PubMedCrossRef
33.
go back to reference Cravens DD, Mehr DR, Campbell JD, Armer J, Kruse RL, Rubenstein LZ. Home-based comprehensive assessment of rural elderly persons: the CARE project. J rural health 2005;21:322-8PubMedCrossRef Cravens DD, Mehr DR, Campbell JD, Armer J, Kruse RL, Rubenstein LZ. Home-based comprehensive assessment of rural elderly persons: the CARE project. J rural health 2005;21:322-8PubMedCrossRef
Metagegevens
Titel
Bewijs voor effectiviteit van Comprehensive Geriatric Assessment in de thuissituatie nog mager: een literatuurreview
Auteurs
E. C. M. van Mulligen-van de Belt
M. Smalbrugge
M. F. I. A. Depla
Publicatiedatum
01-10-2013
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Tijdschrift voor Gerontologie en Geriatrie / Uitgave 5/2013
Print ISSN: 0167-9228
Elektronisch ISSN: 1875-6832
DOI
https://doi.org/10.1007/s12439-013-0042-4