Does comprehensive geriatric assessment (CGA) in an outpatient care setting affect the causes of death and the quality of palliative care? A subanalysis of the age-FIT study.
Dahlqvist. Jenny J; Ekdahl. Anne A; Friedrichsen. Maria M
Key Findings
- CGA did not change the main causes of death, which were mostly heart and brain‑vessel problems.
- Patients who received CGA got more support from specialized palliative care teams (p=0.01).
- No measurable improvement in overall palliative care quality was seen.
Practical Outcomes
- For biohackers and self‑experimenters, this study offers little direct guidance. It suggests that comprehensive geriatric assessments may boost specialist palliative support, but they don’t appear to affect mortality or overall end‑of‑life care quality in the outpatient setting.
Summary
A study looked at whether a detailed health check for older adults (called comprehensive geriatric assessment) changed why they died or improved end‑of‑life care. It found no difference in death causes, but the group that got the assessment received more help from specialist palliative teams, though overall care quality didn’t improve.
Abstract
The purposes of this study were to retrospectively study whether comprehensive geriatric assessment (CGA) given to community-dwelling old patients with high health care usage has effects regarding: (1) the cause of death and (2) the quality of the provided palliative care when compared to patients without CGA-based care. This study includes secondary data from a randomised controlled trial (RCT) with 382 participants that took place in the periods 2011-2013. The present study examines all electronical medical records (EMR) from the deceased patients in the original study regarding cause of death [intervention group (IG) N = 51/control group (CG) N = 66] and quality of palliative care (IG N = 33/CG N = 41). Descriptive and comparative statistics were produced and the significance level was set at p < 0.05. The causes of death in both groups were dominated by cardiovascular and cerebrovascular diseases with no statistical difference between the groups. Patients in the intervention group had a higher degree of support from specialised palliative care teams than had the control group (p = 0.01). The present study in an outpatient context cannot prove any effects of CGA on causes of death. The study shows that CGA in outpatient care means a higher rate of specialised palliative care, but the study cannot show any effects on the palliative quality parameters measured. Further studies with statistical power are needed.
Study Information
pubmed
2019
2019-05-08T00:00:00.000Z
10.1007/s41999-019-00198-w
3
27