Ageing Clinical Trial
Official title:
Comprehensive Geriatric Assessment in Primary Care: The Fit for Late Life
Comprehensive Geriatric Assessment is an effective process to identify and address the needs of older patients. In the United Kingdom this usually takes place in acute care or in the patients home. This project will assess the feasibility of implementing this service in primary care.
With the ageing of the United Kingdom population, it is crucial that evidence on optimal
healthcare is effectively translated into improved clinical practice to both maximise the
health and independence of older people as well as contain costs. Comprehensive Geriatric
Assessment (CGA) is a multidimensional, interdisciplinary process used to identify and
address the complex healthcare needs of older people. Evidence of its effectiveness has been
confirmed in a number of systematic reviews and meta-analyses and beneficial outcomes
reported include improved function and independence. However its implementation across
healthcare settings remains variable. This study aims to establish the feasibility,
acceptability and cost of implementing a Comprehensive Geriatric Assessment Clinic in a
single primary care practice.
The Fit for Later Life Project describes the implementation of a Comprehensive Geriatric
Assessment Clinic in primary care for older people who referred by their General
Practitioner (GP). We will utilise a mixed-methods design including Normalisation Process
Theory (NPT), a sociological toolkit designed to explore how different stakeholders engage
with the real-world process of translating evidence into practice. Interviews and focus
groups will be used to collect data from patients, carers and health professionals on
coherence, cognitive participation, collective action, and reflexive monitoring. These data
will be thematically analysed to identify barriers, strengths and weaknesses for the
implementation of a Comprehensive Geriatric Assessment Clinic in primary care. A clinical
audit of the records of older people who are service users at the participating practice
will be conducted and an assessment will be made of the costs of the clinic. Together these
data will provide implementation guidelines describing the feasibility and acceptability of
a United Kingdom primary care Comprehensive Geriatric Assessment clinic.
The planned outcome is guidelines for the implementation of a Comprehensive Geriatric
Assessment Clinic in United Kingdom primary care. The barriers and facilitators that affect
starting and running the service will be described as will the patients who could
potentially attend and those who actually attend. The costs will also be determined.
This research is funded by the National Institute for Health Research Collaboration for
Leadership in Applied Health Research and Care (NIHR CLAHRC) Wessex.
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Observational Model: Case-Only, Time Perspective: Prospective
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