Premium
An In‐Home Nurse‐Administered Geriatric Assessment for Hypoalbuminemic Older Persons: Development and Preliminary Experience
Author(s) -
Reuben David B.,
Effros Rita B.,
Hirsch Susan H.,
Zhu Xiaoming,
Greendale Gail A.
Publication year - 1999
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1999.tb05206.x
Subject(s) - hypoalbuminemia , medicine , malnutrition , geriatrics , polypharmacy , intervention (counseling) , nursing , psychiatry
BACKGROUND: Although malnutrition in older persons is a common, potentially treatable condition, few data indicate that treatments for this disorder can be effective. OBJECTIVE: To develop and preliminarily evaluate a two‐component intervention that includes a nurse‐administered, in‐home assessment to identify potentially remediable causes of hypoalbuminemia and protocols to treat these problems. DESIGN: A pre‐test post‐test case‐series. SETTING: An academic geriatrics practice. PARTICIPANTS: Seventeen persons aged 65 and older with serum albumin levels ± 3.8 g/dL; eight of the participants received pre‐and post‐test outcome measures. INTERVENTION: Nurse‐administered standardized assessment and intervention protocols. MEASUREMENTS: Serum albumin, Medical Outcome Study (MOS) SF‐36, serum IL‐la and b, TNF a, IL‐6, and lymphocyte markers of immune function. RESULTS: The assessment took 87 minutes, on average, and generated a mean 4.2 recommendations. Among the eight subjects with pre‐ and post‐test measures, serum albumin increased by 0.2 g/dL (P = .035). Compared with baseline, two T cell markers of immune function demonstrated changes consistent with better function. CONCLUSIONS: These preliminary data support the potential benefit of a nurse‐administered assessment coupled with protocols to address remediable contributors to hypoalbuminemia.