Universität zu Köln

Meyer, Anna Maria, Siri, Giacomo ORCID: 0000-0001-8006-0668, Becker, Ingrid ORCID: 0000-0001-5829-3553, Betz, Thomas, Boedecker, August W., Robertz, Joerg W., Krause, Olaf, Benzing, Thomas, Pilotto, Alberto and Polidori, Maria Cristina . The Multidimensional Prognostic Index in general practice: One-year follow-up study. Int. J. Clin. Pract.. HOBOKEN: WILEY. ISSN 1742-1241

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Abstract

Background Older patients' health problems in general practice (GP) can often not be assigned to a specific disease, requiring a paradigm shift to goal-oriented, personalised care for clinical decision making. Purpose To investigate the predictive value of the comprehensive geriatric assessment (CGA)-based Multidimensional Prognostic Index (MPI) in a GP setting with respect to the main healthcare indicators during the 12 months following initial evaluation. Methods One hundred twenty-five consecutive patients aged 70 years and older were enrolled in a GP and followed up to one year. All patients underwent a CGA based on which the MPI was calculated and subdivided into three risk groups (MPI-1, 0-0.33 = low risk, MPI-2, 0.34-0.66 = moderate risk and MPI-3, 0.67-1, severe risk). Grade of Care (GC), hospitalization rate, mortality, nursing home admission, use of home care services, falls, number of general practitioner contacts (GPC), of geriatric resources (GR) and geriatric syndromes (GS) during the 12 months following initial evaluation were collected. Results The MPI was significantly associated with number of GS (P < .001), GR (P < .001), GC (P < .001) as well as with the average number of GPC per year (mean 10.4, P = .046). Interestingly, the clinical judgement of the general practitioner, in this case knowing his patients for 16 years on average, was associated with adverse outcomes to a similar extent than the prediction offered by the MPI (GP/adverse outcomes and MPI/adverse outcomes P < .001). Conclusion The MPI is strongly associated with adverse outcomes in older GP patients and strongly predicts the number of GPC up to one year after initial evaluation. Considering the feasibility and the strong clinimetric properties of the MPI, its collection should be encouraged as early as possible to disclose risk conditions, implement tailored preventive strategies and improve cost-effectiveness of healthcare resources use.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Meyer, Anna Maria UNSPECIFIED UNSPECIFIED UNSPECIFIED Siri, Giacomo UNSPECIFIED orcid.org/0000-0001-8006-0668 UNSPECIFIED Becker, Ingrid UNSPECIFIED orcid.org/0000-0001-5829-3553 UNSPECIFIED Betz, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Boedecker, August W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Robertz, Joerg W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Krause, Olaf UNSPECIFIED UNSPECIFIED UNSPECIFIED Benzing, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Pilotto, Alberto UNSPECIFIED UNSPECIFIED UNSPECIFIED Polidori, Maria Cristina UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-141695
DOI:	10.1111/ijcp.13403
Journal or Publication Title:	Int. J. Clin. Pract.
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1742-1241
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language COMPREHENSIVE GERIATRIC ASSESSMENT; ONE-YEAR MORTALITY; OLDER-PEOPLE; FRAILTY; QUESTIONNAIRE; VALIDATION; PREDICTION; DEFICIT Multiple languages Medicine, General & Internal; Pharmacology & Pharmacy Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/14169