|
|
||||||||
Correspondence: Address correspondence to Cynthia Boyd, MD, MFL Building, 7th Floor, 5200 Eastern Avenue, Baltimore, MD 21224. E-mail: cyboyd{at}jhmi.edu
Purpose: The purpose of this study was to test the feasibility of a new model of health care designed to improve the quality of life and the efficiency of resource use for older adults with multimorbidity. Design and Methods: Guided Care enhances primary care by infusing the operative principles of seven chronic care innovations: disease management, self-management, case management, lifestyle modification, transitional care, caregiver education and support, and geriatric evaluation and management. To practice Guided Care, a registered nurse completes an educational program and uses a customized electronic health record in working with two to five primary care physicians to meet the health care needs of 50 to 60 older patients with multimorbidity. For each patient, the nurse performs a standardized comprehensive home assessment and then collaborates with the physician, the patient, and the caregiver to create two comprehensive, evidence-based management plans: a Care Guide for health care professionals, and an Action Plan for the patient and caregiver. Based in the primary care office, the nurse then regularly monitors the patient's chronic conditions, coaches the patient in self-management, coordinates the efforts of all involved health care professionals, smoothes the patient's transitions between sites of care, provides education and support for family caregivers, and facilitates access to community resources. Results: A 1-year pilot test in a community-based primary care practice suggested that Guided Care is feasible and acceptable to physicians, patients, and caregivers. Implications: If successful in a controlled trial, Guided Care could improve the quality of life and efficiency of health care for older adults with multimorbidity.
Key Words: Chronic disease Nursing Primary care Multimorbidity
This article has been cited by other articles:
|
D A Ganz, G E Alkema, and S Wu It takes a village to prevent falls: reconceptualizing fall prevention and management for older adults Inj. Prev., August 1, 2008; 14(4): 266 - 271. [Abstract] [Full Text] [PDF] |
||||
|
J. H Wasson Adapting what is known BMJ, April 26, 2008; 336(7650): 950 - 951. [Full Text] [PDF] |
||||
|
C. Boult, L. Reider, K. Frey, B. Leff, C. M. Boyd, J. L. Wolff, S. Wegener, J. Marsteller, L. Karm, and D. Scharfstein Multidimensional Geriatric Assessment: Back to the Future Early Effects of "Guided Care" on the Quality of Health Care for Multimorbid Older Persons: A Cluster-Randomized Controlled Trial J. Gerontol. A Biol. Sci. Med. Sci., March 1, 2008; 63(3): 321 - 327. [Abstract] [Full Text] [PDF] |
||||
HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
---|
All GSA journals | Journals of Gerontology Series A: Biological Sciences and Medical Sciences | Journals of Gerontology Series B: Psychological Sciences and Social Sciences |