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Design of a consensus-based geriatric assessment tailored for older chronic kidney disease patients: results of a pragmatic approach

2021; Elsevier BV; Volume: 12; Issue: 5 Linguagem: Inglês

10.1007/s41999-021-00498-0

1878-7657

Carlijn Voorend, Hanneke Joosten, Noeleen Berkhout-Byrne, Adry Diepenbroek, Casper Franssen, Willem Jan W. Bos, Marjolijn van Buren, Simon P. Mooijaart, Arjan van Alphen, Noeleen Berkhout-Byrne, Fenna van Breda, Marjolijn van Buren, Henk Boom, Willem Jan W. Bos, Adry Diepenbroek, Mariëlle H. Emmelot‐Vonk, Casper Franssen, Sandrine Gaillard, Nel Groeneweg, Bettie Hoekstra, Nienke Hommes, Francoise Hoornaar, Hanneke Joosten, Joep Lagró, Elisabeth J R Litjens, F. Molenaar, Simon P. Mooijaart, Aegida Neradová, Mike Peters, Wilma Veldman, Carlijn Voorend, Lidwien Westerbos, Carlijne Westerman - van der Wijden, Judith Wierdsma, Marc H. Hemmelder, J.J. Homan van der Heide, Karen Prantl, Ton J. Rabelink, Sophia de Rooij, Coen D.A. Stehouwer,

Nutrition and Health in Aging

Abstract Purpose Unidentified cognitive decline and other geriatric impairments are prevalent in older patients with advanced chronic kidney disease (CKD). Despite guideline recommendation of geriatric evaluation, routine geriatric assessment is not common in these patients. While high burden of vascular disease and existing pre-dialysis care pathways mandate a tailored geriatric assessment, no consensus exists on which instruments are most suitable in this population to identify geriatric impairments. Therefore, the aim of this study was to propose a geriatric assessment, based on multidisciplinary consensus, to routinely identify major geriatric impairments in older people with advanced CKD. Methods A pragmatic approach was chosen, which included focus groups, literature review, inventory of current practices, an expert consensus meeting, and pilot testing. In preparation of the consensus meeting, we composed a project team and an expert panel (n = 33), drafted selection criteria for the selection of instruments, and assessed potential instruments for the geriatric assessment. Results Selection criteria related to general geriatric domains, clinical relevance, feasibility, and duration of the assessment. The consensus-assessment contains instruments in functional, cognitive, psychological, somatic, patient preferences, nutritional status, and social domains. Administration of (seven) patient questionnaires and (ten) professional-administered instruments, by nurse (practitioners), takes estimated 20 and 40 min, respectively. Results are discussed in a multidisciplinary meeting including at least nephrology and geriatric expertise, informing nephrology treatment decisions, and follow-up interventions among which comprehensive geriatric assessment. Conclusion This first multidisciplinary consensus on nephrology-tailored geriatric assessment intent to benefit clinical care and enhance research comparability for older patients with advanced CKD.