Usefulness of the BRIEF-Multidimensional Prognostic Index (BRIEF-MPI) to identify older adults' healthcare needs to be addressed with a Personalized Prevention Program in general practice: preliminary data from the PrimaCare_P3 study.

BACKGROUND

In Europe around 40% of people aged ≥ 65 years are affected by multiple non-communicable chronic diseases (NCDs). The Comprehensive Geriatric Assessment (CGA) showed its usefulness in early identifying healthcare needs of older people with NCDs to develop a care plan to meet these needs. PrimaCare_P3 study aims at assessing healthcare needs of older people referring to their general practitioners (GPs) to plan a personalised prevention programme (PPP) based on the results of the CGA-based short version of the Multidimensional Prognostic Index (BRIEF-MPI).

METHODS

612 participants with at least one NCDs were included in the intervention group (IG) by twenty GPs from four geographical areas. Functional, cognitive, nutritional, social and co-habitation conditions, co-morbidity, polytherapy, and vaccination status were assessed. Following the CGA-based BRIEF-MPI assessment, participants were provided with a PPP, consisting of targeted indications and interventions including prescribed specialistic examinations, if needed.

RESULTS

Polytherapy and nutritional status were the most impaired domains with 59% of participants showing severe polypharmacy requiring a deprescribing strategy on GP's judgement while 25% of participants being malnourished or overweight/obese. Moreover, 22% of participants showed cognitive impairment requiring intervention, 18.5% were at risk of social isolation and/or loneliness, and 16.5% had some form of functional impairments in activities of daily living. Missing vaccinations according to the National Vaccination Prevention Plan (PNPV) were anti-influenza (34%), anti-COVID-19 (45%), anti-pneumococcus (74%), anti-herpes zoster (89%).

CONCLUSIONS

These data suggest that the CGA-based BRIEF-MPI assessment could effectively identify older adults' healthcare needs to be addressed with a PPP in general practice setting.

TRIAL REGISTRATION: Registered on clinicaltrials.gov, NCT06224556, 05-01-2024.