Developing a Delphi consensus on the domains and conduct of brief geriatric assessments in Singapore.

Abstract

Background: Comprehensive geriatric assessment (CGA) is a process supporting a multidimensional assessment of the health and well-being of older adults and leads to the development of long-term personalized care plans. CGA is resource intensive, hence shorter forms such as brief geriatric assessments (BGA) could be alternatives. However, little is known about BGA's implementability in community and primary care settings. To understand the core requirements for BGA in Singapore's community and primary care settings, an electronic two-round Delphi study with Singaporean clinical experts was conducted.

Methods: Statements were informed by a previous scoping review and three study advisors. Statements related to: (i) target population, (ii) essential domains and sub-domains, and (iii) approach to BGA administration and implementation. Sixteen participants identified as experts in geriatric or family medicine were invited. Consensus was defined a priori as 75% agreement and an interquartile range of ≤ 1.

Results: Fifteen participants responded, and 45/72 and 11/31 statements reached consensus in round one and two respectively. Round two contained statements that did not reach consensus and were modified or added based on feedback. Participants agreed on: (a) targeting selected older adults for BGA to identify geriatric syndromes, (b) physical, psychological, function, mobility/balance, and social status as domains to assess for BGA, and (c) healthcare professionals administering BGA.

Conclusion: Results suggest using BGA to identify high-risk older adults for CGA, potentially saving resources. Additional research is needed to determine identification of older adults for BGA, and feasibility of interventions for older adults after a BGA.