Evidence map›Paper›PMID 41469541›Full record

Trial reportBMC primary care2025

Barriers to and facilitators of comprehensive geriatric assessment in primary care in France: a qualitative study exploring physicians' and nurses' experiences.

Veronique Orcel, Emilie Ferrat, Laura Moscova, Laura Vigneron, Bastien Michau, Jacques Cittée, Florence Adeline, Etienne Audureau, Meoïn Hagège

Registry-linked trialAbstract readPragmatic Clinical TrialRandomized Controlled Trial
In one paragraph

Trial report in BMC primary care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02664454 (Compared Efficacy of Nurse-led and GP-led Geriatric Assessment in PrImary Care), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02664454 nacompletednot on this map

Compared Efficacy of Nurse-led and GP-led Geriatric Assessment in PrImary Care: A Pragmatic Three-arm Cluster Randomized Controlled Trial

TypeinterventionalSponsorAssistance Publique - Hôpitaux de ParisRan2016 to 2018Enrolled750ConditionsMultimorbidity, Geriatric AssessmentArmshealth care organization
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Veronique OrcelDepartment of General Practice, Univ Paris Est Creteil (UPEC), Health faculty, Creteil, 94010, France. veronique.orcel@laposte.net.
Emilie FerratDepartment of General Practice, Univ Paris Est Creteil (UPEC), Health faculty, Creteil, 94010, France.
Laura MoscovaDepartment of General Practice, Univ Paris Est Creteil (UPEC), Health faculty, Creteil, 94010, France.
Laura VigneronDepartment of General Practice, Univ Paris Est Creteil (UPEC), Health faculty, Creteil, 94010, France.
Bastien MichauDepartment of General Practice, Univ Paris Est Creteil (UPEC), Health faculty, Creteil, 94010, France.
Jacques CittéeDepartment of General Practice, Univ Paris Est Creteil (UPEC), Health faculty, Creteil, 94010, France.
Florence AdelineDepartment of General Practice, Univ Rennes 1, Rennes Cedex, 35 043, France.
Etienne AudureauUniv Paris Est Creteil (UPEC), INSERM U955, IMRB (CEpiA Team), Creteil, 94010, France.
Meoïn HagègeUniv Paris Est Creteil (UPEC), INSERM U955, IMRB (CEpiA Team), Creteil, 94010, France.

Funding

public-sector funding from the French Ministry of Health in 2014 (Programme de Recherche sur la Performance du Système des Soins PREPS14370_K140707
6 · The paper itself

Abstract

backgroundComprehensive geriatric assessment (CGA) is intended to address the complex care needs of frail, older adults. The CEpiA cluster-randomized trial assessed the effectiveness of CGA in France as part of complex interventions in two arms: a CGA adapted for use in primary care was conducted by a registered nurse (RN) or a general practitioner (GP). The trial's shared decision aid for the CGA-personalized care plan (PCP) was novel in two ways: tailored to primary care and aiming to improve patient engagement. The study found no significant effect on mortality, functional independence, or quality of life but suggested a reduced risk of unplanned hospital admission with GP-led CGA. It also highlighted the need to explore the CGA's perceived utility and feasibility in routine practice. In the present qualitative study, nested within the CEpiA trial, we aimed to identify barriers to and facilitators of CGA in primary care, as perceived by healthcare professionals.

methodsWe conducted a qualitative study of French primary care professionals (RNs and GPs) having participated in the CEpiA trial between March 2017 and January 2018. Nineteen semi-structured interviews (16 GPs, 3 RNs) from trial arms delivering CGA were conducted. Analysis combined grounded-theory-based, thematic analysis with an interpretative, phenomenological analysis (analytical pluralism).

resultsParticipants valued the adapted CGA's relevance but reported four main barriers: time constraints, poor suitability for some patients, challenges in subsequently implementing actions, and ethical concerns. Facilitators included good uptake of the tool and flexible use, and its function as a frailty-thinking guide rather than serving solely as an assessment tool. The participants reported benefits for patients, primary care providers, and the discipline of general practice.

conclusionsA CGA adapted for use in primary care was perceived to be valuable, relevant, and capable of integration into routine practice. The study's results prompted five key elements for implementation and optimizing CGA use in primary care: digital feasibility, flexible framework, patient-centered communication, organizational support, and patient selection. Future work should include the development of an online CGA-PCP platform, embedding ethical precautions through transparent decision-making, involve patients in CGA design, and identify which patient profiles derive the greatest benefit.

trial registrationClinicalTrials.gov NCT02664454. Registration date: 2016-01-27.

Indexed as

Attitude of Health PersonnelGeriatric AssessmentNursesPrimary Health CareAgedFemaleFranceGeneral PractitionersHumansInterviews as TopicMaleMiddle AgedQualitative ResearchGeneral practiceGeriatric assessmentNursesPrimary health careQualitative researchUtilization

Identifiers

PMID41469541
PMCPMC12754865

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.