Could the Geriatric Mobile Team trial (GerMoT) inclusion criteria be a pragmatic approach to identifying older adults who may be a relevant target group for integrated care interventions?

purposePatients with the traditional definition of multimorbidity, with 2 or more chronic diseases, are a very large and heterogeneous group who differ considerably depending on which set of disorders they suffer from. This paper describes the baselines characteristics of the GerMoT cohort and investigates if the GerMoT inclusion criteria could be used to identify a subgroup of multimorbid patients who may be considered a relevant target group for integrated care interventions.

methodParticipants were 75 years or older, had 3 or more visits to the Emergency Department in the last 18 months, had 3 or more diseases diagnosed according to different ICD-10 chapters and lived in their own home. GerMoT is a randomized-controlled trial comparing proactive outpatient care based on Comprehensive Geriatric Assessment with usual care. The participant's living arrangements, frailty, grip strength, cognition, physical activity, activities of daily living, quality of life, and physical performance were recorded at baseline.

results450 participants were included with a mean age of 83 years (range 75-100); 54% were female. 54% of the cohort lived alone and 44% needed some home adaptation to manage at home. This group had high levels of multimorbidity with a mean of 7.2 (SD = 2.5) diagnoses in different ICD-10 chapters per patient and suffered from pain (80%) and mobility issues (64%). However, they had low levels of frailty (60% non-frail, 13% severely frail) and 90% were independent or partially independent with basic ADLs.

conclusionThe GerMoT inclusion criteria could be a pragmatic way to identify a subgroup of multimorbid people with frequent emergency department use who may be considered a relevant target group for integrated care interventions.