Researchers: Esther Iecovich¹, Aya Biderman¹, Yan Presss^1,2, Svetlana Zlomonson³, Tali Samson

Background: Comprehensive geriatric assessment (CGA) is performed by a multidisciplinary team and is aimed to assess the bio-psycho-social condition of frail older adults who suffer from chronic co-morbidities and functional deterioration. Previous studies showed that adherence to the recommendations has benefits for both the patients and the health care system. Though, most of the recommendations are not implemented. Therefore, there is lack of knowledge regarding the barriers and reasons for non-adherence.

Objectives: To examine what types of recommendations are not implemented and identify the barriers and reasons for non-adherence by family physicians, patients and family primary caregivers.

Method: A prospective study that will include 400 dyads of older patients and their primary family caregivers who underwent a CGA and their family physicians. Data collection will include face-to-face interviews using structured questionnaires in Hebrew, Russian and Arabic and data that will be drawn from computerized medical databases.

Findings: The major reasons for referral to CGA were cognitive deterioration and functional decline, whereas in Maccabi cognitive deterioration was significantly more prevalent than in Clalit. The 6 major recommendations in Clalit were: reduction or adding medicines, referral to the national insurance institute, daycare center/senior citizen club and physiotherapy. In Maccabi the 6 prevalent recommendations were imaging and laboratory exams, changes in medicines, referral to a medical consultant, and vitamins. The recommendations most not implemented in the Clalit were: changes at home, visiting a daycare center/senior citizen club, referral to a social worker, physiotherapist and dietician, and food supplements. In Maccabi the recommendations mostly not implemented were: Installing an alarm system using a hearing device, making changes at home, visiting a daycare center/senior citizen club, referral to a occupational therapist, food supplements. In both HMOs the percentatge of recommendations implementation was an average of 80%.

Conclusions: Although a high percentage of recommendations are being implemented, emphasis is more put on medical recommendation and lesser on welfare and social care

Recommendations: More emphasis should be put on integrating medical and social care to better meet the diverse and comprehensive needs of the older patients

Research end date: 02/2017