Usefulness of the BRIEF-Multidimensional Prognostic Index (BRIEF-MPI) to identify older adults' healthcare needs to be addressed with a Personalized Prevention Program in general practice: preliminary data from the PrimaCare_P3 study.
Alberto Pilotto, Wanda Morganti, Emanuele Seminerio, Eleonora Lacorte, Carlo Custodero, Nicola Veronese, Peter Fielding, Carolina Massone, Paola Piscopo, Elisa Fabrizi, Patrizia Lorenzini, Alberto Magni, Gaetano Piccinocchi, Carlo Ignazzi, Lorenza Busco
Abstract
Open AccessBACKGROUND: In Europe around 40% of people aged ≥ 65 years are affected by multiple non-communicable chronic diseases (NCDs). The Comprehensive Geriatric Assessment (CGA) showed its usefulness in early identifying healthcare needs of older people with NCDs to develop a care plan to meet these needs. PrimaCare_P3 study aims at assessing healthcare needs of older people referring to their general practitioners (GPs) to plan a personalised prevention programme (PPP) based on the results of the CGA-based short version of the Multidimensional Prognostic Index (BRIEF-MPI). METHODS: 612 participants with at least one NCDs were included in the intervention group (IG) by twenty GPs from four geographical areas. Functional, cognitive, nutritional, social and co-habitation conditions, co-morbidity, polytherapy, and vaccination status were assessed. Following the CGA-based BRIEF-MPI assessment, participants were provided with a PPP, consisting of targeted indications and interventions including prescribed specialistic examinations, if needed. RESULTS: Polytherapy and nutritional status were the most impaired domains with 59% of participants showing severe polypharmacy requiring a deprescribing strategy on GP's judgement while 25% of participants being malnourished or overweight/obese. Moreover, 22% of participants showed cognitive impairment requiring intervention, 18.5% were at risk of social isolation and/or loneliness, and 16.5% had some form of functional impairments in activities of daily living. Missing vaccinations according to the National Vaccination Prevention Plan (PNPV) were anti-influenza (34%), anti-COVID-19 (45%), anti-pneumococcus (74%), anti-herpes zoster (89%). CONCLUSIONS: These data suggest that the CGA-based BRIEF-MPI assessment could effectively identify older adults' healthcare needs to be addressed with a PPP in general practice setting. TRIAL REGISTRATION: Registered on clinicaltrials.gov, NCT06224556, 05-01-2024.