Reflections on the implementation of the Italian guidelines on comprehensive geriatric assesment for the older persons

Abstract

A fundamental phase in the life of new Guidelines is the implementation, which responds to the need to facilitate their adoption with interventions and procedures of proven effectiveness to increase their impact on public health. The implementation should follow a scientific method, and therefore shares many characteristics and the rigorous approach of clinical research. However, it differs in purposes, methods, and aims by addressing factors that include identifying and resolving barriers and facilitators in the adoption of evidence-based clinical innovations. The use of comprehensive geriatric assessment (CGA) can be facilitated by technological tools, with the possibility of early diagnosis of several chronic conditions, monitoring and management of the diseases typical of older people and, finally, to personalized care and optimization of healthcare resources. However, remote CGA also has limitations, including technology requirements, data security/privacy, and the need for comprehensive evaluation and simplicity. In this document we present the history and the model of implementation of the Italian guidelines on CGA in older persons. The standardization of CGA in older adults across different settings is particularly important in countries like Italy, that have among the oldest world population and where broader implementation of CGA, also outside traditional geriatric settings, has become a health priority that cannot longer be delayed.