The effectiveness of comprehensive geriatric assessment intervention for older people in outpatient setting: a systematic review / meta-analysis
Abstract
Introduction: Comprehensive geriatric assessment (CGA) is a multidisciplinary diagnostic and treatment process that identifies a frail older person's medical, psychosocial, and functional limitations. The effectiveness of CGA in patients admitted to hospitals is well known, but it is still unclear whether those benefits translate to the outpatient setting. Therefore, this study aims to assess the effectiveness of CGA in the hospital outpatient setting.
Methods: We collected randomized clinical trials comparing CGA and usual care in the outpatient setting for older patients (aged 60 years and above). We used a combination of the keywords and their synonyms in several databases: PubMed, EMBASE Proquest, and the clinical trial registry. Risk of bias (RoB) assessment was done using RoB 2 from Cochrane. GRADE assessment for outcome mortality and hospitalization was also done.
Result: We found seven articles with a total of 3,254 subjects undergoing CGA in the outpatient clinic. The implementation of CGA is highly varied from center to center. Low-quality evidence demonstrated that CGA did not significantly affect all-cause mortality, patient satisfaction, hospitalization, functional status of basic and instrumental activities of daily living, cognitive, and cost. Very low-quality evidence showed favorable quality of life in CGA group at 3 and 12 months, as reported by individual studies. No difference was found in all studies relating to the risk of hospitalization.
Conclusion:…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 3,254 participants or records.
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