Effects of integrated care with case management and nutritional counselling for frail older adults with nutritional risk in the primary care setting.

Autor:	Hsiao ML; Department of Nursing, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707, Sec. 3, Chung Yang Rd., Hualien 970, Taiwan., Su CY; Department of Nutrition, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707, Sec. 3, Chung Yang Rd., Hualien 970, Taiwan., Loh CH; Center for Aging and Health, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.; Department of Family Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707 Sec. 3, Chung Yang Rd., Hualien 970, Taiwan.; Department of Family Medicine, College of Medicine, Tzu Chi University, No. 701, Sec. 3, Chung Yang Rd., Hualien 970, Taiwan., Kao SL; Department of Family Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707 Sec. 3, Chung Yang Rd., Hualien 970, Taiwan.; Department of Family Medicine, College of Medicine, Tzu Chi University, No. 701, Sec. 3, Chung Yang Rd., Hualien 970, Taiwan.
Jazyk:	angličtina
Zdroj:	Family practice [Fam Pract] 2024 Dec 02; Vol. 41 (6), pp. 1010-1017.
DOI:	10.1093/fampra/cmae011
Abstrakt:	Background: The effects of integrated care with case management and nutritional counselling for frail patients with nutritional risk are unclear. Objectives: To assess the impact of the integrated care model for frail patients with nutritional risk in the primary care setting. Methods: This was a retrospective observational study. We enrolled 100 prefrail or frail patients according to Clinical Frailty Scale (CFS) aged ≥ 60 years with nutritional risk from the geriatric clinic. We implemented the frailty intervention model, including integrated care with comprehensive geriatric assessments (CGA), case management, and nutritional counselling by the dietitian. We obtained measures of CGA components, physical performance, body mass index (BMI), and daily caloric intake before and after the 2-month care program. We used the Wilcoxon signed-rank test to analyse differences after the care program and applied multiple linear regression to determine the predictive factors for CFS improvement. Results: Among the 100 patients (mean age, 75.0 ± 7.2 years; females, 71.0%; frail patients, 26%), 93% improved their CFS status, and 91% achieved > 80% of recommended daily caloric intake after the care program. The Mini Nutritional Assessment Short-Form significantly improved after the program. BMI and daily caloric intake increased significantly after nutritional counselling. The post-test short physical performance battery (SPPB) significantly increased with a faster 4 m gait speed. Baseline poor CFS was a significant predictor for CFS improvement. Conclusions: Integrated care with case management and nutritional counselling for prefrail and frail patients with nutritional risk in the primary care setting may improve physical performance and nutritional status. (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
Databáze:	MEDLINE
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