Profiling the geriatric patient: Implications for future pathways of patient-centered care in geriatrics

Abstract

Introduction.– The Older Persons and Informal Caregivers Survey Minimal DataSet (TOPICS-MDS) instrument has been successfully incorporated into all research projects of the Dutch National Care for the Elderly Programme (NCEP). The aim of this study was to develop a standardized CEP for the TOPICS-MDS that can be used as primary endpoint. Methods.– Vignette studies were conducted. In total, 124 community dwelling elderly aged≥65 years (78±7 years) and 76 informal caregivers (63±12 years) participated as raters in these studies. The raters assessed the general well-being (GWB) of elderly cases described in vignettes on a scale (0–10). The cases were described with regard to eight TOPICS-MDS domains: morbidity, functional limitations, emotional well-being, pain experience, cognitive functioning, social functioning, self-perceivedhealth and self-perceived quality of life (QOL). Results.– A mixed linear model that included all eight domains as fixed factors and had a R2 of 0.84. The domain emotional wellbeing had the strongest influence on the GWB scores, while the domain functional limitations had the weakest influence on the GWB scores, regression weights of 0.19 and 0.12, respectively. Whether the rater was an older person or an informal caregiver did not influence the regression weights of the fixed factors. Key conclusions.– A CEP for TOPICS-MDS based on the preferences of older persons and informal caregivers gave most weight to emotional well-being and least weight to limitations in daily functioning. Our findings suggested it was not necessary to establish an alternative CEP based on the preference weights of informal caregivers.