Design of a consensus-based geriatric assessment tailored for older chronic kidney disease patients: results of a pragmatic approach
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Published:2021-04-19
Issue:5
Volume:12
Page:931-942
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ISSN:1878-7657
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Container-title:European Geriatric Medicine
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language:en
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Short-container-title:Eur Geriatr Med
Author:
Voorend Carlijn G. N.ORCID, Joosten Hanneke, Berkhout-Byrne Noeleen C., Diepenbroek Adry, Franssen Casper F. M.ORCID, Bos Willem Jan W.ORCID, Van Buren MarjolijnORCID, Mooijaart Simon P.ORCID, van Alphen Arjan, Berkhout-Byrne Noeleen, van Breda Fenna, van Buren MarjolijnORCID, Boom Henk, Bos Willem Jan, Diepenbroek Adry, Emmelot-Vonk Marielle, Franssen Casper, Gaillard Carlo A. J. M., Groeneweg Nel, Hoekstra Bettie, Hommes Nienke, Hoornaar Francoise, Joosten Hanneke, Lagró Joep, Litjens Elisabeth, Molenaar Femke, Mooijaart Simon P.ORCID, Neradova Aegida, Peters Mike, Veldman Wilma, Voorend CarlijnORCID, Westerbos Lidwien, Westerman - van der Wijden Carlijne, Wierdsma Judith, Hemmelder M., Homan van der Heide J. J., Prantl K., Rabelink A. J., de Rooij S., Stehouwer C.,
Abstract
Abstract
Purpose
Unidentified cognitive decline and other geriatric impairments are prevalent in older patients with advanced chronic kidney disease (CKD). Despite guideline recommendation of geriatric evaluation, routine geriatric assessment is not common in these patients. While high burden of vascular disease and existing pre-dialysis care pathways mandate a tailored geriatric assessment, no consensus exists on which instruments are most suitable in this population to identify geriatric impairments. Therefore, the aim of this study was to propose a geriatric assessment, based on multidisciplinary consensus, to routinely identify major geriatric impairments in older people with advanced CKD.
Methods
A pragmatic approach was chosen, which included focus groups, literature review, inventory of current practices, an expert consensus meeting, and pilot testing. In preparation of the consensus meeting, we composed a project team and an expert panel (n = 33), drafted selection criteria for the selection of instruments, and assessed potential instruments for the geriatric assessment.
Results
Selection criteria related to general geriatric domains, clinical relevance, feasibility, and duration of the assessment. The consensus-assessment contains instruments in functional, cognitive, psychological, somatic, patient preferences, nutritional status, and social domains. Administration of (seven) patient questionnaires and (ten) professional-administered instruments, by nurse (practitioners), takes estimated 20 and 40 min, respectively. Results are discussed in a multidisciplinary meeting including at least nephrology and geriatric expertise, informing nephrology treatment decisions, and follow-up interventions among which comprehensive geriatric assessment.
Conclusion
This first multidisciplinary consensus on nephrology-tailored geriatric assessment intent to benefit clinical care and enhance research comparability for older patients with advanced CKD.
Publisher
Springer Science and Business Media LLC
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