Adherence to recommendations of inpatient geriatric consultation teams: a multicenter observational study
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RESEARCH PAPER
Adherence to recommendations of inpatient geriatric consultation teams: a multicenter observational study Mieke Deschodt1,2 · Anthony Jeuris3 · Bastiaan Van Grootven4,5 · Eline Van Waerebeek6 · Evie Gantois5 · Johan Flamaing1,7 · Anja Velghe8 Received: 11 July 2020 / Accepted: 11 September 2020 © The Author(s) 2020
Key summary points Aim We evaluated the adherence to recommendations of inpatient geriatric consultation teams and the team and recommendation characteristics impacting the adherence rates. Findings The overall adherence rate to the recommendations was 69.7%. Adherence rate increased if recommendations were given to allied health professionals or by more experienced consultation teams and when fewer recommendations were given. Message Replication is needed in an international multicenter study with a specific attention given to the quality of the recommendations and the follow-up by the teams. Abstract Purpose Inpatient geriatric consultation teams (IGCTs) provide recommendations for the care of older patients hospitalized on non-geriatric wards based on comprehensive geriatric assessment. The lack of adherence to their recommendations hinders the potential impact of IGCTs. We evaluated the adherence to IGCT recommendations and determined which team and recommendation characteristics are related to higher adherence rates. Methods Multicenter observational study in older adults aged ≥ 75 years admitted to an acute non-geriatric ward. Demographic and adherence data were collected for 30 consecutive patients. A cross-sectional survey mapped team and organizational characteristics of the participating IGCTs. Results Analyses were conducted in 278 patients (51.4% male, mean age 82.5 years, and median length of stay 10 days). There was a median number of 3 recommendations (range 1–13) per patient. The overall adherence rate was 69.7%. Recommendations related to ‘social status’ (82.4%) and ‘functional status/mobility’ (73.3%) were best adhered to. Recommendations related to ‘medication’ (53.2%) and ‘nutritional status’ (59.1%) were least adhered to. Adherence rates increased if recommendations were given to allied health professionals (OR = 6.37, 95% CI = 1.15–35.35) or by more experienced IGCTs (OR = 1.34, 95% CI = 1.04–1.72) and decreased when more recommendations were given (OR = 0.51, 95% CI = 0.33–0.80). Conclusion Adherence rate to IGCT recommendations increased if given to allied health professionals or by more experienced IGCTs and when fewer recommendations were given. Study replication in an international multicenter study with a larger number of centers and evaluating the quality of the recommendations is suggested. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s41999-020-00397-w) contains supplementary material, which is available to authorized users. * Mieke Deschodt [email protected] 1
Department of Public Health and Primary Care, Gerontology and Geriatrics, KU Leuven, Leuven, Belgium
2
Department of Pu
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