Interdisciplinary geriatric primary care evaluation and management: two-year outcomes.

Area of Science:

• Geriatric Medicine
• Primary Care
• Health Services Research

Background:

• Long-term efficacy of interdisciplinary outpatient Geriatric Evaluation and Management (GEM) in primary care settings remains understudied.
• This study evaluates the 2-year outcomes of a GEM program for older adults.

Purpose of the Study:

• To assess the long-term efficacy of an interdisciplinary outpatient Geriatric Evaluation and Management (GEM) program.
• To determine the impact of GEM on health status, function, and quality of life in older adults over two years.

Main Methods:

• A 2-year randomized clinical trial involving 128 veterans aged 65 and older at a Veterans Affairs Medical Center.
• Participants were randomized to either outpatient GEM or usual care (UC).
• Two-year follow-up analyses included health status, function, quality of life (affect, cognition), and mortality.

Main Results:

• GEM significantly improved health perception, social activity, general well-being, life satisfaction, and cognitive function (MMSE scores) over two years.
• GEM also led to smaller increases in instrumental activities of daily living (IADL) impairments and fewer clinic visits compared to usual care.
• No significant differences were observed in activities of daily living (ADL) scores, hospitalizations, or mortality between GEM and UC groups.

Conclusions:

• An interdisciplinary primary care approach combining comprehensive assessment and long-term management (GEM) significantly improves outcomes for targeted older adults.
• The positive effects of the GEM model may continue to improve over time, demonstrating its effectiveness in managing healthcare for older adults.