Structured Clinical Tools for Periodic Health Assessment of Older Adults in Primary Care: A Scoping Review

初级保健中老年人定期健康评估的结构化临床工具:范围界定综述

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Abstract

BACKGROUND AND AIMS: Delivering preventive care to older adults presents challenges due to the lack of consensus on screening items, particularly regarding geriatric syndromes. Furthermore, chronological age often differs from biological age, which requires primary care clinicians (PCCs) to assess each patient's aging profile and tailor preventive interventions accordingly. Periodic Health Assessments (PHAs) offer an opportunity to administer preventive care. While several authors have developed Structured Clinical Tools (SCTs) to assist clinicians during PHAs, no SCT is widely used across clinicians. The study aims to identify existing SCTs for the PHA of older adults and evaluate their content, formats, and practical usability. METHODS: We conducted a scoping review following the 6-step methodology recommended by Arksey and O'Malley (2005) and Levac (2010). We searched in PubMed, CINAHL, and Ageline, as well as in the grey literature, using keywords related to four main concepts: older adults, primary care, periodic health assessment, and SCT. We retrieved SCTs published in French and English between 2000 and 2024. Data were screened and charted by two independent reviewers. For step six (consultation), we gathered opinions of 10 PCCs on the practical usability of different SCTs. RESULTS: Among the 8029 identified publications, we retrieved 16 distinct SCTs. Design objectives and conception processes of these SCTs varied. They were presented in various formats, including questionnaires, tables, schemas, checklists, acronyms, and mnemonics. While all SCTs addressed geriatric syndromes, only two adapted their recommendations to patients' aging profiles. Consulted PCCs emphasized that an ideal SCT should be integrated into an electronic health record, accommodate various aging profiles, and rely on evidence-based medicine. CONCLUSIONS: A reliable and user-friendly SCT for the PHA of older adults would facilitate the delivery of preventive care. However, no published SCTs to date meet the expectations of PCCs. Further research is necessary to develop one.

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