Geriatric consultation: is there a future?
Geriatric consultation: is there a future?
Age Ageing (2007) 36 (1): 1-2. doi: 10.1093/ageing/afl125
The process of disciplined identification of common geriatric syndromes and risks in targeted individuals with careful prescription of preventives and treatments would seem, at face value, a logical response to a growing population of frail older patients in acute care hospitals. Yet, the evidence that such an approach produces measurable improvements in patient outcomes remains extremely limited, other than in the context of designated geriatric units.
Hospital geriatric consultation services are now commonplace in most developed nations. Their role and function varies considerably, ranging from ‘triage’ services manned by individual geriatricians designed to identify patients suitable for transfer to post-acute services, through to well-resourced teams comprising geriatricians, specialist nurses and therapists who actively contribute to care provision in mixed ward settings. It is this latter, more intensive style of service that has been subject to the most intense evaluation. Although early studies showed promise in terms of improved patient outcomes [1], the majority found no differences when assessed against a range of clinical and administrative outcomes [2–6]. A meta-analysis of comprehensive geriatric assessment services identified no effects of this form of service [7].
