Tijdschrift voor Gerontologie en Geriatrie

, Volume 44, Issue 5, pp 215–227 | Cite as

Bewijs voor effectiviteit van Comprehensive Geriatric Assessment in de thuissituatie nog mager: een literatuurreview

  • E. C. M. van Mulligen-van de Belt
  • M. Smalbrugge
  • M. F. I. A. Depla
Article
First Online:

Samenvatting

Achtergrond

De meeste ouderen vinden het belangrijk zo lang mogelijk zelfstandig te blijven functioneren. Gerichte opsporing en behandeling van factoren die de functionele zelfstandigheid bedreigen, middels een comprehensive geriatric assessment (CGA), kan het zelfstandig functioneren mogelijk bevorderen. Dit artikel doet verslag van een literatuurstudie naar het effect van comprehensive geriatric assessment in de thuissituatie.

Methode

In Pubmed (1977–2012) is gezocht naar RCT’s die de effectiviteit van multidisciplinaire, multidimensionele CGA bij ouderen in de thuissituatie onderzocht hebben. Er werden data geëxtraheerd over effectiviteit, kosten en factoren die het effect van het CGA positief of negatief hebben beïnvloed.

Resultaten

Negen RCT’s werden geïncludeerd. Op één studie na was de kwaliteit matig tot goed. In drie van de zes studies naar functionele status en in twee van de vier studies naar kwaliteit van leven werd een positief effect gevonden. Geen effect werd gevonden op het aantal ziekenhuisopnames en verpleeghuisopnames of op mortaliteit. De meeste studies lieten een stijging zien van de totale gezondheidszorgkosten.

Conclusie

CGA thuis heeft een beperkt gunstig effect op functionele status en kwaliteit van leven. Er zijn aanwijzingen dat CGA thuis het meeste effect heeft bij relatief goed functionerende ouderen.

Trefwoorden

comprehensive geriatric assessment thuis functionele status kwaliteit van leven verpleeghuisopname mortaliteit faal-en succesfactoren 

Abstract

Background

Most elderly people attach great value to staying functionally independent for as long as possible. A targeted detection and treatment of factors that threaten functional independence, through comprehensive geriatric assessment, might promote this. This paper describes a review on the effect of in-home comprehensive geriatric assessment.

Methods

A search was carried out in Pubmed (1977–2012) for randomized controlled trials investigating the effectiveness of multidisciplinary multidimensional in-home geriatric assessment. Data was extracted about effectiveness, costs and factors that had a positive or negative influence on the outcome of CGA.

Results

Nine RCTs could be included in the study. All studies were of moderate to good quality, except for one study of poor quality. A positive effect was found in three out of six studies on functional status and in two out of four studies on quality of life. No effect was found on number of hospital admissions, nursing home admissions and on mortality. Most studies showed a rise in total health care expenditure.

Conclusion

In-home CGA has a modest positive effect on functional status and quality of life. Evidence suggest that in-home CGA might be most effective in elderly that have a relatively high level of functioning.

Keywords

Frail elderly health services for the aged preventive home visits outcome assessment (health care) 
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Copyright information

© Bohn, Stafleu van Loghum 2013

Authors and Affiliations

  • E. C. M. van Mulligen-van de Belt
    • 1
  • M. Smalbrugge
    • 2
  • M. F. I. A. Depla
    • 2
  1. 1.Ouderengeneeskunde Birkhoven ZorggoedAmersfoortThe Netherlands
  2. 2.Afdeling Huisartsgeneeskunde & Ouderengeneeskunde en EMGO+VU medisch centrumAmsterdamThe Netherlands

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