Management of long term conditions

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Policy developments strengthening primary care provide the specialty of geriatric medicine an opportunity to review and strengthen its partnership with primary care. The Department of Health has promulgated a three level model for the management of long term conditions: self management, disease management and case management for those with complex and multiple conditions. It is this latter group that geriatricians have most to offer, backed up by the evidence-based practice of comprehensive geriatric assessment.

The British Geriatrics Society Primary and Continuing Care SIG offer a model of care for frail older people, and this is intended to be useful for the effective implementation of services for such people, including case management
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Randomized Trial Finds Improved Function for Older Adults in Primary Care Intervention

Research Findings from the Institute for Geriatric Social Work

Frail older adults who receive a form of behavioral therapy and care management from a social worker in their primary care setting experience significant improvement in physical functioning, a new IGSW study has shown. While the benefits of integrating social workers into primary care -- for older adult patients and for the healthcare system -- have long been hypothesized and informally observed, rigorous clinical trials rarely have attempted to document the results of such efforts.

The study, conducted by the Institute for Geriatric Social Work in conjunction with Partners in Care Foundation, is a randomized control trial that tests the effects of social workers in primary care using a protocolized intervention, Problem-Solving Therapy, to treat frail older adult patients at Kaiser Permanente.

"These findings show integrating social workers into primary care can help address the multifaceted needs of older adults, increasing satisfaction of patients and physicians," said Dr. Scott Miyake Geron, the study's principal investigator and director of IGSW. Dr. Susan Enguidanos, one of the researchers on the study, who is assistant professor at the Leonard Davis School of Gerontology at the University of Southern California and a research associate at Partners in Care Foundation, added that "by translating evidence-based protocols into real-world practice, this study addresses some of the gaps in our knowledge of the benefits of geriatric social work."

Geron and Enguidanos will discuss the study's findings at the upcoming Annual Scientific Meeting of the Gerontological Society of America. The presentation, Social Work in Primary Care: Final Results of a Randomized Trial, will take place on Saturday, November 22, from 3:30 p.m. to 5 p.m., Gaylord National Resort and Convention Center, National Harbor, Md.

The Institute for Geriatric Social Work (IGSW) at Boston University is dedicated to advancing social work practice with older adults and their families. IGSW was established in 2002 through a grant from The Atlantic Philanthropies (USA) Inc. to improve the quality and increase the availability of gerontological social work practice by helping social workers meet the challenges presented by the diverse and growing aging population.

Website: http://www.bu.edu/igsw