Comprehensive Geriatric Assessment in Primary Care: A Feasibility RCT

  • Research type

    Research Study

  • Full title

    ‘Comprehensive Geriatric Assessment’ for frail older adults within a primary care setting: A randomised feasibility trial

  • IRAS ID

    230223

  • Contact name

    Reza Safari

  • Contact email

    m.safari@derby.ac.uk

  • Sponsor organisation

    University of Derby

  • Duration of Study in the UK

    0 years, 8 months, 31 days

  • Research summary

    Older people count for one in five attendances to the Accident and Emergency (A+E). The 2016 NHS Benchmark Report indicates that 45% of admissions to hospitals might be associated with frailty. Comprehensive Geriatric Assesment (CGA) offers an integrated managed process for older people with frailty or vulnerability. This model coincides with the existing policy direction towards an integrated health and social care approach. As outlined in the ‘Silver Book’ CGA considers multidimensional domains, including Physical medical condition, Mental health, Functioning, Social circumstances and Environment.

    Evidence suggests that CGA in hospitals, acute care setting, and care homes is effective. Within this setting CGA results in less functional decline and a higher probability of staying at home after discharge in elderly people with frailty. Despite the benefit of CGA to frail older people, offering routine population screening for frailty is impractical and costly due to low specificity of available tools. However, based on recently published research (Cleg 2016), routine primary care electronic health record data could be used to identify frailty in primary care.

    The proposed study aims to explore the feasibility of implementing a tailored CGA for frail older people, evaluate staff and patients perception of the intervention, assess health care resource usage and cost, and to measure key participants health related outcomes such as Health related quality of life, function, mobility and loneliness as well as the cost and resource use. Eligible elderly people with frailty in two GP practices will be randomly allocated to either CGA or usual care. The CGA will be delivered in patient’s houses by Advanced Clinical Practitioners. Outcomes will be assessed before intervention and at 6 months post-intervention.

  • REC name

    Yorkshire & The Humber - Leeds East Research Ethics Committee

  • REC reference

    17/YH/0336

  • Date of REC Opinion

    20 Nov 2017

  • REC opinion

    Further Information Favourable Opinion