Comprehensive geriatric assessment and multidisciplinary team interventions for hospitalized older adults: A scoping review

Jung-Yeon Choi; Vasuki Rajaguru; Jaeyong Shin; Kwang-Il Kim

doi:10.1016/j.archger.2022.104831

Comprehensive geriatric assessment and multidisciplinary team interventions for hospitalized older adults: A scoping review

Arch Gerontol Geriatr. 2023 Jan:104:104831. doi: 10.1016/j.archger.2022.104831. Epub 2022 Oct 4.

Authors

Jung-Yeon Choi¹, Vasuki Rajaguru², Jaeyong Shin³, Kwang-Il Kim⁴

Affiliations

¹ Departments of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
² Department of Healthcare Management, Graduate School of Public Health, Yonsei University, Seoul, South Korea.
³ Institute of Health Service Research, College of Medicine, Yonsei University, Seoul, South Korea; Deparment of Preventive Medicine, College of Medicine, Yonsei University, Seoul, South Korea. Electronic address: drshin@yuhs.ac.
⁴ Departments of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea. Electronic address: kikim907@snu.ac.kr.

PMID: 36279806
DOI: 10.1016/j.archger.2022.104831

Abstract

Background/objectives: Comprehensive geriatric assessment (CGA) is a multidisciplinary diagnostic and treatment process to evaluate medical, psychosocial, and functional capability. It is useful to develop a coordinated and integrated plan for frail older patients. This study aimed to examine the current scope of CGA based multidisciplinary team interventions in acute care setting to improve the health outcomes for older adults.

Methods: We searched electronic databases: PubMed, Ovid, PsychINFO, Scopus, RISS and KoreaMed from 2011 to 2021. The selected articles were extracted by three reviewers and cross checked by the fourth reviewer to resolve any conflicts. Data were synthesized and analyzed descriptively and thematically. Articles are nested three themes: inpatient (IN), emergency room (ER) and oncology patient (ONCO).

Results: Of the 1830 articles that were screened, 710 were potentially eligible. Finally, 26 articles were selected and categorized as IN (n=8), ER (n=7) and ONCO (n=11). Geriatricians and nurses participated in most of the multidisciplinary teams followed by other health professionals. The most effective primary outcomes were focused and retrieved across five domains, screening, prevention, treatment, quality of care, and rehabilitation. The subdomains are problem lists which is common and problematic among hospitalized older patients and retrieved from the most commonly used multidisciplinary interventions according to each domain.

Conclusion: CGA based multidimensional intervention (MDI) are likely to be an effective in care of older adults. There is remarkable paradigm shift required to improve better health outcomes for hospitalized older adults. It also suggests that there is a need to design the CGA based MDI to build a standardized protocol for older adults to maintain functional capacity and increase likelihood of living in their own home.

Keywords: Comprehensive geriatric assessment; Health status; Hospitalization; Multidisciplinary; Readmission; Transitional care.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Geriatric Assessment* / methods
Geriatricians
Hospitalization*
Humans
Patient Care Team