STEP - Europäische Leitlinie für das standardisierte evidenzbasierte präventive Assessment älterer Menschen in der medizinischen Primärversorgung

Sandholzer, Hagen; Hellenbrand, Wiebke; Renteln-Kruse, Wolfgang von; Weel, Chris van; Walker, Peter

doi:10.1055/s-2004-836107

Cited by 40 publications

(24 citation statements)

References 121 publications

(130 reference statements)

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“…The STEP screening instrument [14][15][16][17] was developed by a group of GPs from seven European countries and consists of a 37-item questionnaire (with 32 clinical items) for the patient, and a shorter questionnaire for the GP who,…”

Section: Methodsmentioning

confidence: 99%

Geriatric assessment in general practice using a screening instrument: is it worth the effort? Results of a South Tyrol Study

2008

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Background: geriatric assessment is a well-established instrument to improve the care of the elderly, but little is known about it in general practice although patients often are known for years. Methods: we used STEP-assessment, an instrument developed by European General Practitioners (GPs), which identifies only problems that can be improved; 37 questions had to be answered by the patient and 4 tests had to be done by the GP. Additionally in the study, GP and patient had to indicate separately which of the problems were seen as relevant and what both accepted to do for improvement. A year later, participating GPs were asked by a not-announced questionnaire to report on improvements and reasons for failure. Results: of the 220 eligible GPs, 45 enrolled a random sample of 894 patients (average age 77 years). In all 7.8 out of 32 possible problems per patient were found. Of those, 1.4 problems were not known to the GP. More than two-thirds of the 'new problems' are perceived as relevant by GP, patient or by both. GPs assessed medical problems and patients assessed social/psychological problems as more relevant. The length and quality of the relationship with the patient was reflected in the number of new problems, with fewer new problems in those well-known. A year later, GPs had offered treatment for 47% of the newly diagnosed problems, with a success-rate of 81%. Conclusion: geriatric screening can detect unidentified problems in general practice. Once detected and dealt with, a high proportion of the undetected problems showed improvement. GPs focussed more on medical, while patients more on psychosocial issues. To increase the outcome of screening, it is necessary to discuss the relevance assessed by the patient.

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Section: Methodsmentioning

confidence: 99%

Geriatric assessment in general practice using a screening instrument: is it worth the effort? Results of a South Tyrol Study

2008

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“…Health status will be assessed using several instruments that measure health-related variables of the person with dementia, including the GP records, the SF-12 Health Survey [46], the standardised assessment for elderly patients in a primary care setting (STEP) [47], the Brief Symptom Inventory (BSI) [48] and the Gesundheitsfragebogen für Patienten (PHQ-D) [49,50]. …”

Section: Methods and Study Designmentioning

confidence: 99%

Life- and person-centred help in Mecklenburg-Western Pomerania, Germany (DelpHi): study protocol for a randomised controlled trial

Thyrian

Fiß

Dreier³

et al. 2012

Trials

103

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BackgroundThe provision of appropriate medical and nursing care for people with dementia is a major challenge for the healthcare system in Germany. New models of healthcare provision need to be developed, tested and implemented on the population level. Trials in which collaborative care for dementia in the primary care setting were studied have demonstrated its effectiveness. These studies have been conducted in different healthcare systems, however, so it is unclear whether these results extend to the specific context of the German healthcare system.The objective of this population-based intervention trial in the primary care setting is to test the efficacy and efficiency of implementing a subsidiary support system on a population level for persons with dementia who live at home.Methods and study designThe study was designed to assemble a general physician-based epidemiological cohort of people above the age of 70 who live at home (DelpHi cohort). These people are screened for eligibility to participate in a trial of dementia care management (DelpHi trial). The trial is a cluster-randomised, controlled intervention trial with two arms (intervention and control) designed to test the efficacy and efficiency of implementing a subsidiary support system for persons with dementia who live at home. This subsidiary support system is initiated and coordinated by a dementia care manager: a nurse with dementia-specific qualifications who delivers the intervention according to a systematic, detailed protocol. The primary outcome is quality of life and healthcare for patients with dementia and their caregivers. This is a multidimensional outcome with a focus on four dimensions: (1) quality of life, (2) caregiver burden, (3) behavioural and psychological symptoms of dementia and (4) pharmacotherapy with an antidementia drug and prevention or suspension of potentially inappropriate medication. Secondary outcomes include the assessment of dementia syndromes, activities of daily living, social support health status, utilisation of health care resources and medication.DiscussionThe results will provide evidence for specific needs in ambulatory care for persons with dementia and will show effective ways to meet those needs. Qualification requirements will be evaluated, and the results will help to modify existing guidelines and treatment paths.Trial registrationNCT01401582

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“…The geriatric assessment tool used in this study was the STEP (“Standardised Assessment for Elderly People in Primary Care”), described in detail by Sandholzer and colleagues [14]. At Leipzig Medical School, the STEP was augmented by the Mini-Mental State Examination (MMSE), two items of the COOP/WONCA charts (an established screening instrument that measures functional capacity at a given time), and the Barthel Index [13,15,16].…”

Section: Methodsmentioning

confidence: 99%

Geriatric assessment in undergraduate geriatric education – a structured interpretation guide improves the quantity and accuracy of the results: a cohort comparison

Igenbergs¹,

Deutsch²,

Frese³

et al. 2013

BMC Med Educ

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BackgroundWith regard to the growing proportion of elderly multimorbid patients, a sound undergraduate geriatric education becomes more important. Therefore we included the execution and interpretation of a comprehensive geriatric assessment (CGA) into a mandatory two-week clerkship at a general practitioner's office. The present study examined the effect of a guide structuring the students’ considerations when interpreting a CGA on the quantity and accuracy of the documented findings and conclusions.MethodsWe compared random samples out of two cohorts of fourth-year medical students (interpreting the CGA with and without using the structured interpretation guide) completing their clerkship between April 2006 and March 2008 with regard to the content of the CGA interpretation and the grades the students achieved for their clerkship documentation, which were substantially determined by the quantity and accuracy of the documentation and interpretation of the CGA.ResultsThe structured interpretation guide led to significantly more mentions of aspects that have to be considered in geriatric patient care and to a higher documentation rate of respective positive results. Furthermore, students who analysed the CGA by using the interpretation guide achieved significantly better grades.ConclusionsAn additional tool structuring medical students’ considerations when interpreting a CGA increases the quantity and the accuracy of the documented findings and conclusions. This may enhance the students’ learning gain.

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STEP - Europäische Leitlinie für das standardisierte evidenzbasierte präventive Assessment älterer Menschen in der medizinischen Primärversorgung

Cited by 40 publications

References 121 publications

Geriatric assessment in general practice using a screening instrument: is it worth the effort? Results of a South Tyrol Study

Geriatric assessment in general practice using a screening instrument: is it worth the effort? Results of a South Tyrol Study

Life- and person-centred help in Mecklenburg-Western Pomerania, Germany (DelpHi): study protocol for a randomised controlled trial

Geriatric assessment in undergraduate geriatric education – a structured interpretation guide improves the quantity and accuracy of the results: a cohort comparison

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