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Comprehensive geriatric assessment in primary care: a systematic review
James W Garrard1, Natalie J Cox2,3,4, Richard M Dodds2,5,6
1Radcliffe Department of Medicine, University of Oxford, Oxford, OX1 2JD, UK. james.garrard@rdm.ox.ac.uk.
Aging Clinical and Experimental Research
|April 11, 2019
Summary
Comprehensive geriatric assessment (CGA) in primary care is acceptable and potentially cost-effective, though evidence for improved survival or function is limited. Further research is needed to optimize its implementation and identify patient suitability.
Area of Science:
- Gerontology
- Primary Care Medicine
- Health Services Research
Background:
- Comprehensive geriatric assessment (CGA) is established in hospital and home settings.
- Implementing CGA in primary care offers improved accessibility to multidisciplinary teams.
- This study appraises evidence for CGA within primary care practices.
Purpose of the Study:
- To systematically review and evaluate the existing evidence on the implementation and outcomes of Comprehensive Geriatric Assessment (CGA) within primary care settings.
Main Methods:
- A PRISMA-compliant systematic review was conducted.
- Searches across five databases identified studies on CGA for individuals aged 65+ in primary care.
- Four heterogeneous studies, with limited bias, were included after screening 9003 titles.
Main Results:
- CGAs were led by geriatricians or nurse practitioners with varied follow-up periods (12-48 months).
- Hospital admission rates showed mixed results; medication adherence improved.
- No significant improvements in survival or functional outcomes were observed, but interventions were well-accepted and potentially cost-effective.
Conclusions:
- Comprehensive geriatric assessment (CGA) in primary care is acceptable and shows variable benefits.
- Further research is required to determine optimal implementation strategies, patient selection criteria, outcome measures, and professional roles for primary care CGA.
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