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Data-processing tool for the practice of standadized gerontologic evaluation:Results of an investigation with the general practitioners in the Alpes ? Maritimes ( France )
David BOUAZIZ, JY GIORDANA, J SAOS, JL PHILIP , D Balas
1 ? Objectives :
It is well known that, old people fragility is an important public health problem. The standardized gerontologic evaluation ( SGE) is a method validated by Rubenstein (1984 ). The recommendation of the scientific council of the APA shows that, a multidimensional evaluation must be used. According to this recommendations, in collaboration with the Gerontologic Observatory of the General Council of Alpes Maritimes , we developed an evaluation software. The first part, is adapted to the daily practice of the general practitioner (GP) :
- tailored with the time of the consultations
- items easy to be reached
- use of analogical visual scale to facilitate a quick interpretation, etc
Our software use the validated international network when they exist and takes into account the frequent fragility risks ( situational , cognition , mood , sensory , nutrition , incontinence, motricity , equilibration, ADL-IADL , pain , iatrogenic risk , pathological risk ). The aim of the study was to demonstrate the feasibility of an GSE by the GP.
2 ? Protocol :
Eighteen General Practitioners were formed to the practice of the SGE and the use of our software. The number of included patients was more than 4.
Included criterion: age > 60 years, informed and agreeing patients.
Excluded criterion: dementia, sensory deficit incompatible with the SGE method , acute disease
After each evaluation, the GPs answered at 8 questions. The real time of evaluation was unaware of the GP.
3 ? Results :
The statistical analysis shows that :
1 ? The real time of evaluation was 20 to 32 minutes ( median : 25 min )
2 ? The GPs had no problem to explain to the patient the interest of the evaluation ( 3,8 / 4 pts )
3 ? The GPs did not reveal any difficulty to correlate SGE with consultation purpose ( 3,7 / 4 pts )
4 ? The evaluation study design suggested is ideal( 3,7 / 4 pts )
5 ? The GPs wanted to continue later on, the evaluation of their patients using complementary tests ( level 2 or more ) ( 3,6 / 4 pts )
About the software :
1 ? The GPs were satisfied by the first level of evaluation ( 9 / 10 pts )
2 ? Even if it?s a new concept , the GPs thought it was very useful and important ( 8,7 / 10 pts )
About the patients :
1- 98 patients included
2- Age 63 to 100 years
3- 54 women / 24 men
4- 11% was malnourished and 51 % had risk of denutrition,
5- 64% was depressed with 32 % in severe depression
6- 68 % of patients complain of pain including18 % with a strong and permanent pain
4 ? Conclusion :
In the present study, we show that, our software is :
- a simple tool easy to use
- acceptable by both patients and doctor?s
- useful to evaluate fragility of old people
We propose to develop other ergonomic tools to facilitate this preventive medicine in the General practice. We consider to supply all GP in the Alpes Maritimes with our software.
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