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Identifying common impairments in frail and dependent older people : validation of the COPE assessment for non-specialised health workers in low resource primary health care settings
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AT, Jotheeswaran, Dias, Amit, Philp, Ian, Beard, John, Patel, Vikram and Prince, Martin (2015) Identifying common impairments in frail and dependent older people : validation of the COPE assessment for non-specialised health workers in low resource primary health care settings. BMC Geriatrics, 15 (1). doi:10.1186/s12877-015-0121-1 ISSN 1471-2318.
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Official URL: http://dx.doi.org/10.1186/s12877-015-0121-1
Abstract
BACKGROUND:
Frail and dependent older people in resource-poor settings are poorly served by health systems that lack outreach capacity. The COPE (Caring for Older PEople) multidimensional assessment tool is designed to help community health workers (CHWs) identify clinically significant impairments and deliver evidence-based interventions
METHODS:
Older people (nā=ā150) identified by CHWs as frail or dependent, were assessed at home by the CHW using the structured COPE assessment tool, generating information on impairments in nutrition, mobility, vision, hearing, continence, cognition, mood and behaviour. The older people were reassessed by local physicians who reached a clinical judgment regarding the presence or absence of the same impairments based upon clinical examination guided by the EASY-Care assessment tool.
RESULTS:
The COPE tool was considered easy to administer, and gave CHWs a sense of empowerment to understand and act upon the needs of older people. Agreement between COPE assessment by CHW and clinician assessors was modest (ranged from 45.8 to 91.3 %) for most impairments. However, the prevalence of impairments was generally higher according to clinicians, particularly for visual impairment (98.7 vs 45.8 %), cognitive impairment (78.4 vs. 38.2 %) and depression (82.0 vs. 59.9 %). Most cases identified by WHO-COPE were clinician confirmed (positive predictive values - 72.2 to 98.5 %), and levels of disability and needs for care among those identified by COPE were higher than those additionally identified by the clinician alone.
CONCLUSIONS:
The COPE is a feasible tool for the identification of specific impairments in frail dependent older people in the community. Those identified are likely to be confirmed as having clinically relevant problems by clinicians working in the same service, and the COPE may be particularly effective at targeting attention upon those with the most substantial unmet needs.
Item Type: | Journal Article | ||||||||
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Subjects: | R Medicine > RA Public aspects of medicine | ||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Social Sciences > Warwick Business School Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Frail elderly -- Care -- Goa (India : State), Frail elderly -- Medical care, Home care services -- Administration, Geriatrics, Older people | ||||||||
Journal or Publication Title: | BMC Geriatrics | ||||||||
Publisher: | BioMed Central Ltd. | ||||||||
ISSN: | 1471-2318 | ||||||||
Official Date: | 14 October 2015 | ||||||||
Dates: |
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Volume: | 15 | ||||||||
Number: | 1 | ||||||||
Number of Pages: | 14 | ||||||||
DOI: | 10.1186/s12877-015-0121-1 | ||||||||
Status: | Peer Reviewed | ||||||||
Publication Status: | Published | ||||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||||
Funder: | Wellcome Trust (London, England) |
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