STEP - Europäische Leitlinie für das standardisierte evidenzbasierte präventive Assessment älterer Menschen in der medizinischen Primärversorgung[1]

STEP - Standardized assessment of elderly people in primary care

Background: There is a need for a standard preventive assessment scheme, which is effective, feasible and acceptable throughout European primary care.

Methods: A consensus based guideline including systematic reviews of the evidence was done by an expert panel of general practitioners (core group) and epidemiologists / geriatricians from seven European countries.

Results: The Step group identified 8 health domains to be considered in a preventive assessment; client`s perspective and attitudes. physical state, functional state, significant symptoms, mental function, social circumstances, medication and primary preventive issues. To select the health areas with a proven preventive potential the strength of scientific evidence and the relevance to primary preventive care was assessed. The final recommendations graded as the preventive primary care impact factor as follows: A1=strongly recommended were hypertension, symptomatic heart failure, urinary incontinence, hearing impairment, vision impairment, falls, breathlessness, depression, dementia, medication review, functional status, activity and physical exercise. A2=recommended: Hypertension over the age of 80, history of myocardial infarction, symptomatic coronary heart disease, atrial fibrillation, history of TIA or stroke, peripheral vascular disease, diabetes, thyroid dysfunction, osteoporosis, lipids, faecal incontinence, weight status, foot problems, oral heath, osteoarthritis, sleeplessness, pain, social circumstances, tobacco and alcohol use, psychological support for patients with chronic disease and (national) immunization & cancer programms.

Conclusions: The rising population of elderly people in Europe gives cause for health care professionals and policy makers to consider optimal ways to preserve health and function in old age. An Evidence based, proactive preventive geriatric assessment can help to promote heath and function in older people.

Keywords

Journal Article - Review - Europe - Meta-Analysis - Review, Academic - Activities of Daily Living - Aged - Chronic Disease - Disabled Persons - Disease Progression - Frail Elderly - Geriatric Assessment/methods - Guidelines - Health Priorities - Human - Mass Screening/methods - Primary Prevention/methods - Public health - Health Services for the Aged/statistics and numerical data - Mass Screening - Support, Non-U.S. Gov't

1 Übersetzte und bearbeitete deutsche Ausgabe mit Autorisierung durch das The Royal College of General Practitioners (RCGP) Copyright Universität Leipzig 2003

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1 Übersetzte und bearbeitete deutsche Ausgabe mit Autorisierung durch das The Royal College of General Practitioners (RCGP) Copyright Universität Leipzig 2003