[Coordination between primary care and a geriatrics service, 20 years later]. / Coordinación entre atención primaria y un servicio de geriatría, 20 años después.

OBJECTIVE: To describe the evolution of the care and coordination activity of a specialized hospital team (Geriatric Home Care-AGD team) in support of Primary Care (PC) for the care of geriatric patients. LOCATION: Health-5 area of the Community of Madrid. PARTICIPANTS, INTERVENTIONS AND MAIN MEASUREMENTS: Evaluation of patients attended at home at the request of PC by AGD, in 1997-1999 and twenty years later, in 2017-2019. Sociodemographic, clinical, functional and mental variables were recorded. Also care data such as time to first visit, average length of stay, origin and destination of patients, reason for consultation and main reason for disability. RESULTS: 524 patients (58% of the total) requested from AP in 1997-1999 and 1196 (72.2% of the total) in 2017-2019 were attended. Currently we show an older patient, more physically and mentally disabled, with a higher prevalence of geriatric syndromes and greater social fragility. Dementia has increased as the main reason for incapacity, with an increase in Comprehensive Geriatric Assessment and clinical control as the main reasons for referral. CONCLUSIONS: in our setting, after 20 years, AGD continues to be an important support for PC in the complex approach to frail elderly patients confined to their homes, who are increasingly vulnerable from a clinical, functional, cognitive and social point of view. It contributes to the management of geriatric syndromes, deprescription, direct hospital admissions when needed without having to go to the emergency department, and a decrease in institutionalization, facilitating the maintenance of the patient at home.

Assessment of student interprofessional education (IPE) training for team-based geriatric home care: does IPE training change students' knowledge and attitudes?

Our study assesses changes in students' knowledge and attitudes after participation in an interprofessional, team-based, geriatric home training program. Second-year medical, physician assistant, occupational therapy, social work, and physical therapy students; third-year pharmacy students; and fourth-year dental students were led by interprofessional faculty teams. Student participants were assessed before and after the curriculum using an interprofessional attitudes learning scale. Significant differences and positive data trends were noted at year-end. Our study suggests that early implementation, assessment, and standardization of years of student training is needed for optimal interprofessional geriatric learning. Additionally, alternative student assessment tools should be considered for future studies.

[Evolution of the profile of patients attended by a hospital Geriatric Home Care Unit in the last 20 years]. / Evolución del perfil de las personas mayores atendidas por una unidad de atención domiciliaria especializada en geriatría en los últimos 20 años.

OBJECTIVE: To describe the evolution of the profile of patients attended by a Geriatric Home Care (GHC) Unit and its care activity in the last two decades. METHODS: Data on the historical activity of the AGD Unit from 2001 to 2020, grouped into 5-year periods, were recorded. Sociodemographic, clinical, functional (Functional Red Cross Scale and Barthel index) and mental (Mental Red Cross Scale) variables were collected, baseline and at inclusion to AGD. Also the waiting time until first visit, mean follow-up, origin of referral, destination at the end of the intervention, reason for consultation and cause of functional dependence were also included. A descriptive analysis was performed with the SPSSv.23 program. RESULTS: Ten thousand six hundred fifty-four patients attended in AGD (1 January 2001 to 31 December 2020). A progressive increase in age and in the number of geriatric syndromes was observed. Patients presented higher functional and cognitive decline, and the number of patients living alone and in need of private assistance increased. The duration of the intervention decreases and Primary Care remains the main source and destination at the end of the intervention, with dementia standing out as the main cause for functional dependence. CONCLUSION: The vulnerability of the populations in need of specialised geriatric care is increasing: patients are older, and have more geriatric syndromes, high functional and cognitive decline, and suffer social frailty; more work is needed to address the role of these support units in the community, as well as their coordination with Primary Care teams.