Prevention of Loneliness, Frailty, Polyphamacy and Falls among Senior European Adults, Journal of Advanced Nursing

In this paper, authors, including Anastasios Rentoumis and Athina Markaki from AfIC, seeked to evaluate specific process components of the Urban Health Centres Europe project; “a coordinated preventive care approach aimed at healthy ageing by decreasing falls, polypharmacy, loneliness and frailty among older persons in community settings of five cities in the United Kingdom, Greece, Croatia, the Netherlands and Spain” co-funded by CHAFEA, EU. Design: Mixed-methods evaluation of specific process components of the Urban Health Centres Europe approach: reach of the target population, dose of the intervention actually delivered and received by participants and satisfaction and experience of main stakeholders involved in the approach. Methods: The Urban Health Centres Europe approach intervention consisted of a preventive assessment, shared-decision making on a care plan and enrolment in one or more of four coordinated care-pathways that targeted falls, polypharmacy, loneliness and frailty. Quantitative data from a questionnaire and quantitative/qualitative data from logbooks were collected among older persons involved in the approach. Qualitative data from focus-groups were collected among older persons, informal caregivers and professionals involved in the approach. Quantitative data were analysed by means of descriptive statistics and multilevel logistic regression models. Qualitative data were analysed through thematic analysis. Results: Having limited function was associated with non-enrolment in falls and loneliness care-pathways (both P<0.01). The mean rating of the approach was 8.3/10 (SD 1.9). Feeling supported by a care professional and meeting people were main benefits for older persons. Mistrust towards unfamiliar care providers, lack of confidence to engage in care activities and health constraints were main barriers towards engagement in care. Conclusions: Although the Urban Health Centres Europe approach was received generally positively, health constraints and psychosocial barriers prevented older person’s engagement in care. Impact: coordinated preventive care approaches for older community-dwelling persons should address health constraints and psychosocial barriers that hinder older person’s engagement in care.