Research Abstract: Advanced Trainee - Oral Presentation Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2023

Pilot study on the feasibility of using Comprehensive Geriatric Assessment for younger frail patients with severe mental illness (#18)

Winona Kwan 1 , Urska Arnautovska 2 , Dan Siskind 3 , Ella Pearson 2 , Andrea Baker 4 , Natasha Reid 5 , Nancy Wang 6 , Emily Gordon 7 , Nicola Warren 8 , Ruth Eleanor Hubbard 9
  1. Queensland Health, Brisbane, QLD, Australia
  2. Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
  3. MIRT, The University of Queensland, Brisbane, Queensland, Australia
  4. Queensland Centre for Mental Health Research, Brisbane, Queensland, Australia
  5. Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
  6. Metro South Addiction and Mental Health Service, Brisbane, Queensland, Australia
  7. Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
  8. Princess Alexandra Hospital, Brisbane, Queensland, Australia
  9. Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia

 

Background

People with severe mental illness have poor physical health and multi-domain problems similar to those seen in older people who are frail. The aim of this pilot study was to investigate one of the pillars of frailty management (Comprehensive Geriatric Assessment [CGA]) in people with severe mental health illness

 

Methods

Participants were recruited from an Addiction and Mental Health Service outpatient clinic. Inclusion criteria: age 18–64 years, frailty index >0.25; written informed consent. CGA was delivered by an Advanced Trainee in Geriatric Medicine with a follow-up appointment at 3–6 months. Semi-structured qualitative interviews were conducted within 4 weeks of the follow-up.

 

Results

Fifteen participants were recruited: 80% male; mean age 47.8 (SD 11.1); mean frailty index 0.34 (SD 0.079). Average times for chart review prior to assessment and face-to-face CGA were 41.4 mins and 51.5 mins respectively.

Qualitative interviews indicated that assessment by 'the specialist' was a positive experience.

Participants were prescribed a mean of 9.7 medications; 93% had obesity; 2 reported a history of falls and 7 had hearing and/or vision impairment. Recommendations for obesity management were made for 11 patients, medication changes were suggested for 10, 9 were referred for allied health input and 4 to medical sub-specialties.

 

Conclusion

In younger people with severe mental illness, CGA is feasible, acceptable and results in an individualized care plan. The effectiveness and cost effectiveness of frailty-focused management for this group are the focus of further studies by our team.