Improving health outcomes among older adults in India: effectiveness and implementability of a novel comprehensive geriatric assessment based intervention.

Q1 Medicine Wellcome Open Research Pub Date : 2024-11-08 eCollection Date: 2023-01-01 DOI:10.12688/wellcomeopenres.19796.3
Jaya Singh Kshatri, Susan Shenkin, Stewart Mercer, David Weller, Subrata Kumar Palo, Sandipana Pati, Daisy Janssen, Sanghamitra Pati
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Abstract

Background: There is significant evidence on the benefits of comprehensive assessment in older adults. But this evidence is primarily from western countries and in secondary care settings. National policies in India recognize this need and envision community-based screening and facility-based assessment programs integrated into the care pathways for the elderly. However, this is yet to translate into specific interventions, primarily due to lack of complex interventions necessary and evidence of their effectiveness. This study aims to design and pilot an integrated (Community + Facility) Elderly Health Status Assessment and Screening (EHSAS) intervention to improve health outcomes of older adults and assess its feasibility for implementation in Indian rural settings.

Methods: We propose a hybrid design where we will build the complex intervention, develop and validate the tools needed, pilot it using an exploratory cluster randomized trial and evaluate its implementatbility using the Exploration-Preparation-Implementation-Sustainment (EPIS) framework.

Conclusions: This study will fill critical gaps in evidence regarding the effectiveness of geriatric screening and assessment in community and primary care settings in low-middle income countries and provide validated tools and implementation models for adoption into national programs.

Registration: CTRI/2023/07/055661.

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改善印度老年人的健康状况:基于老年病综合评估的新型干预措施的有效性和可实施性。
背景:有大量证据表明,对老年人进行综合评估大有裨益。但这些证据主要来自西方国家和二级医疗机构。印度的国家政策认识到了这一需求,并设想将以社区为基础的筛查和以设施为基础的评估计划纳入老年人护理路径。然而,这尚未转化为具体的干预措施,主要原因是缺乏必要的复杂干预措施及其有效性证据。本研究旨在设计和试行一项综合(社区 + 机构)老年人健康状况评估和筛查(EHSAS)干预措施,以改善老年人的健康状况,并评估其在印度农村地区实施的可行性:我们提出了一个混合设计方案,即我们将建立复杂的干预措施,开发并验证所需的工具,利用探索性分组随机试验进行试点,并利用探索-准备-实施-持续(EPIS)框架评估其可实施性:这项研究将填补中低收入国家在社区和初级保健环境中进行老年病筛查和评估的有效性方面的重要证据空白,并提供经过验证的工具和实施模式,供国家计划采用:CTRI/2023/07/055661.
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来源期刊
Wellcome Open Research
Wellcome Open Research Biochemistry, Genetics and Molecular Biology-Biochemistry, Genetics and Molecular Biology (all)
CiteScore
5.50
自引率
0.00%
发文量
426
审稿时长
1 weeks
期刊介绍: Wellcome Open Research publishes scholarly articles reporting any basic scientific, translational and clinical research that has been funded (or co-funded) by Wellcome. Each publication must have at least one author who has been, or still is, a recipient of a Wellcome grant. Articles must be original (not duplications). All research, including clinical trials, systematic reviews, software tools, method articles, and many others, is welcome and will be published irrespective of the perceived level of interest or novelty; confirmatory and negative results, as well as null studies are all suitable. See the full list of article types here. All articles are published using a fully transparent, author-driven model: the authors are solely responsible for the content of their article. Invited peer review takes place openly after publication, and the authors play a crucial role in ensuring that the article is peer-reviewed by independent experts in a timely manner. Articles that pass peer review will be indexed in PubMed and elsewhere. Wellcome Open Research is an Open Research platform: all articles are published open access; the publishing and peer-review processes are fully transparent; and authors are asked to include detailed descriptions of methods and to provide full and easy access to source data underlying the results to improve reproducibility.
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