Plataforma para otimização da avaliação geriátrica ampla na atenção básica

Abstract

Increasing population aging and multi-morbidity lead to increased demand for health care and increased spending. Emerging technologies, specifically electronic and mobile healthcare platforms, can be used to prevent illness and help seniors and healthcare professionals maintain a healthy and functional life. This study developed and evaluated a m-health platform for Comprehensive Geriatric Assessment (CGA) to be used in Primary Care, providing the professional with indications of preventive action and, consequently, delaying the establishment of damages to the health of the elderly. It is an exploratory research in the modality of technological development, with a qualitative-quantitative approach, divided in three stages: selection of CGA tests; process of design and conception of the conceptual model. In the first, a narrative and integrative review of the literature on elderly and elderly evaluation scales used in Brazil and in the world was done, followed by filtering, and selection of the scales to compose the mobile platform, within the universe of tests obtained in the previous phase, by two specialists (1 in neurology and one in elderly health), and finally, the evaluation of professionals in the area of collective health to refer to the selected scales considering their feasibility and sensitivity for basic care. The second step consisted in seeking the definition of the conceptual model through a study of the product's functionalities, its requirements, and modeling it through Unified Modeling Language diagrams. The third and last step includes the evaluation via the Rating Scale Mobile form (1 = inadequate and 5 = excellent) together with 22 professionals, 11 of them from Basic Health Care and 11 from Information and Communication Technologies (ICT) to form feedback of suggestions. The study was approved by the Research Ethics Committee with opinion nº 3,181,233. The review resulted in 29 scales, of which 9 were selected for the m-health benchmark. The modeling of the system defined the need for an initial anamnesis; contain physical, mental, and functional exams in your database; to raise problems and to identify priorities according to the results, and thus, to suggest an option of intervention, being also defined the prerequisites, the classes and the relationships of the subjects involved. The platform beta was evaluated positively (general median = 4.0 [4.0-4.25]) and greater than 4 in all dimensions (engagement = 4.0 [4.0-4.0]), functionality = 4.5 [4.0-5.0], aesthetics = 4.0 [3.0-5.0], and information = 4.0 [4.0-4.0]), obtaining Krippendorff's Alpha equal to 0.13. The evaluation by areas was also positive in both the biomedical area and the ICT, obtaining, respectively, 4.0 [4.0-4.0] and 4.0 [4.0-4.0] in the engagement dimension; 5.0 [4.0-5.0] and 4.0 [4.0-5.0] in the functionality dimension; 4.0 [3.0-5.0] and 4.0 [3.0-4.0] in aesthetics; and 4.0 [4.0-5.0] and 4.0 [3.5-4.0] in the information dimension). Thus, it is concluded that the m-health platform for Broad Geriatric Assessment to be used in Basic Care developed has a high degree of quality according to ICT professionals and potential users