TY - JOUR
T1 - Anticipatory care planning for older adults: a trans-jurisdictional feasibility study
AU - Corry, Dagmar
AU - Doherty, Julie
AU - McCann, Adrienne
AU - Doyle, Frank
AU - Cardwell, Christopher
AU - Carter, Gillian
AU - Clarke, Mike
AU - Fahey, Tom
AU - Gillespie, Paddy
AU - McGlade, Kieran
AU - O'Halloran, Peter
AU - Wallace, Emma
AU - Brazil, Kevin
PY - 2020/6/18
Y1 - 2020/6/18
N2 - BACKGROUND: As the population of older adults' increases, the complexity of care required to support those who choose to remain in the community has also increased. Anticipatory Care Planning (ACP) through earlier identification of healthcare needs is evidenced to improve quality of life, decrease the number of aggressive futile interventions, and even to prolong life. AIM: To determine the feasibility of a cluster randomised trial to evaluate the implementation and outcomes of Anticipatory Care Planning (ACP) in primary care to assist older adults identified as at risk for functional decline by developing a personalised support plan. METHOD: GP practices were randomised into control/intervention groups stratified by jurisdiction [Northern Ireland (UK) and the Republic of Ireland (RoI)], and by setting (urban and rural). Participants were included if they were a) aged ≥70 years, b) 2 or more chronic medical conditions, c) 4 or more prescribed medications. The Anticipatory Care Plan consisted of home visits where the study nurse discussed patients' goals and plans. An action plan was put in place following consultation with patient's GPs and study Pharmacist. RESULTS: Eight primary care practices participated; four in the UK and four in the RoI. Sample n = 64. Data was collected pertaining to patient quality of life, mental health, healthcare utilisation, costs, perception of person-centred care, and the use of potentially inappropriate medication. CONCLUSION: Unique insights relating to the trans-jurisdictional delivery of healthcare services in the UK and RoI were observed which has implications on service delivery for older adults.
AB - BACKGROUND: As the population of older adults' increases, the complexity of care required to support those who choose to remain in the community has also increased. Anticipatory Care Planning (ACP) through earlier identification of healthcare needs is evidenced to improve quality of life, decrease the number of aggressive futile interventions, and even to prolong life. AIM: To determine the feasibility of a cluster randomised trial to evaluate the implementation and outcomes of Anticipatory Care Planning (ACP) in primary care to assist older adults identified as at risk for functional decline by developing a personalised support plan. METHOD: GP practices were randomised into control/intervention groups stratified by jurisdiction [Northern Ireland (UK) and the Republic of Ireland (RoI)], and by setting (urban and rural). Participants were included if they were a) aged ≥70 years, b) 2 or more chronic medical conditions, c) 4 or more prescribed medications. The Anticipatory Care Plan consisted of home visits where the study nurse discussed patients' goals and plans. An action plan was put in place following consultation with patient's GPs and study Pharmacist. RESULTS: Eight primary care practices participated; four in the UK and four in the RoI. Sample n = 64. Data was collected pertaining to patient quality of life, mental health, healthcare utilisation, costs, perception of person-centred care, and the use of potentially inappropriate medication. CONCLUSION: Unique insights relating to the trans-jurisdictional delivery of healthcare services in the UK and RoI were observed which has implications on service delivery for older adults.
U2 - 10.3399/bjgp20X711197
DO - 10.3399/bjgp20X711197
M3 - Article
C2 - 32554648
AN - SCOPUS:85086692680
SN - 0960-1643
VL - 70
JO - The British journal of general practice : the journal of the Royal College of General Practitioners
JF - The British journal of general practice : the journal of the Royal College of General Practitioners
IS - Supp 1
ER -
