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Table 2 Comprehensive geriatric care models

From: Effects of comprehensive geriatric care models on postoperative outcomes in geriatric surgical patients: a systematic review and meta-analysis

Geriatric care model POPS (Harari et al) [31] POSH (McDonald et al) [15] HELP (Inouye et al) [14] gPCC (Ekman et al) [12] LIFE (Hempenius et al) [13] MDCa
Author, study type Partridge,[17]RCT McDonald [15], PC Adogwa [22], RC Chen [10], Cluster RCT Olsson [24], Pre-post Hempenius [13], 2013, RCT Hempenius [23], 2016, RCT Cronin [11], PC Tarazona-Santabalbina [19], RC Nussbaum, [16]RC Souwer [18],
Pre-post
Pre-operative 1. CGA
2. Assessment of Cognitive Function,
Frailty, Anaemia,
Cardiac evaluation
1. CGA
2. Risk assessment focused on -• Cognition• Mobility • Functional status • Co-morbidities Medications • Nutrition • Hydration • Pain • Advanced care planning
1. CGA
2. Screened for 6 delirium risk factors: • Cognitive impairment • Immobility • Sleep deprivation • Dehydration • Vision impairment • Hearing impairment
1. CGA includes: • Need for additional support after discharge • ADL level • Social lifestyle
• Symptoms severity 2.Patient - provider joint Rx plan
1. CGA 2. Checklist to standardize intervention • Mobility • Co-morbidities • Nutrition • Loss of vision & hearing •Medication • Depression •Incontinence • Cognitive, social & instrumental ADL
• Delirium ICP
1. CGA [18, 19]
2. Rehab care included training, dietary, cognitive, & emotional guidance [18]
3. Nutritional assessment
[19]
4. Risk assessment for functional (VES) & polypharmacy status [11]
Post-operative • CGA • ICP • Home visit follow-up therapy • Mx of co-morbidity & pain • Delirium assessment • Enhancement of mobility & nutrition • Counselling for discharge & post-hospital care
assessment
• Orientation • Therapeutic activities • Early mobilization • Feeding assistance • Sleep enhancement • Vision & hearing reinforcement •Delirium • Shared decision: Patient-provider partnership •Documentation:
Decisions & assessments according to PCC
• Geriatric nurse daily visit • Follow-up using postoperative order set assessing functionality, pain & medication
[11]
•Nutritional assessment & FTRP [16]
Polypharmacy NR Reduction recorded NR NR NR Recorded
[18]
Delivery team •Geriatrician • Nurse specialist •Occupational therapist • Geriatrician • Nurse • Surgeons •Anaesthesiologists • Geriatrician • Geriatric nurse • Pharmacist • Nutritionist • Rehab therapists • Trained volunteers • Physicians
• Surgeons
• Nurse
•Physiotherapists
•Occupational therapists
• Patient representatives
•Geriatrician
• Geriatric nurse
•Geriatrician • Geriatric nurse • Oncology nurse • Surgeons • Residents
• Dieticians
• Physical therapists
  1. Abbreviations: ADL Activities of daily living, CGA Comprehensive geriatric assessment, FTRP Fast-track recovery pathway, gPCC Gothenburg person centred care, HELP Hospital Elder Life Program, ICP Individual care plan, LIFE Liaison Intervention in Frail Elderly, MDC Multidisciplinary care, NR Not recorded, PC Prospective cohort, POPS Proactive care of older people undergoing surgery, POSH Perioperative Optimization of Senior Health, Rehab Rehabilitation, RC Retrospective cohort, RCT Randomized controlled trial, Rx Treatment, Pre-post Pre-intervention and post-intervention design, VES Vulnerable elder survey
  2. aThe pathways which were not using standard care models (like HELP, POPS, POSH, etc.) were grouped into the MDC group