Do Allied Health Practitioners add value to perioperative clinics? Observations from an Older Persons clinic.
Jared Tower1, Katherine Gregorevic1, Ross Bicknell1, Michelle Preeo1, Kwang Lim1, Aruska D’Souza1, Alyssa Griffiths 1, Rachel Aitken11Royal Melbourne Hospital, Parkville , Victoria, Australia
Abstract
Background: Older people possess a greater likelihood for comorbidities and geriatric syndromes, which are associated with high perioperative risk and poor postoperative outcomes. The Perioperative care of Older Patients undergoing Surgery clinic is a perioperative service targeted to meet the needs of this population who are considering surgery. A Physiotherapist is a novel addition to a geriatric perioperative clinic and their role was to execute a comprehensive physical function assessment and provide exercise and education interventions to clients.
Methods: Observational cohort study of clients, who attended this clinic at a tertiary hospital between; nested dates of 1/3/22 to 1/9/22. A Geriatrician, Perioperative Anaesthetist and Physiotherapist completed a preoperative multidisciplinary Comprehensive Geriatric Assessment including demographic, clinical, physiotherapy and surgical data. Statistical analysis was completed via Mann-Whitney U and Chi square tests.
Results: During the data collection period, 80 clients attended the clinic, of whom 33 (42.3%) clients did not proceed with surgery. Non-surgery decision was associated with older age (p=0.001), formal services (p=0.039) and lower cognition for clients who completed the Rowland Universal Dementia Assessment Scale (p=0.003). Conversely, Clinical Frailty Scale (p=0.277), gait speed (p=0.238) and residence (p=0.771) were not associated with surgical decisions.
Discussion: Allied Health Clinicians can contribute to the multidimensional assessment of geriatric clients considering surgery. While many of the physical function assessments were not associated with surgical decisions, this information can be used to tailor exercise and education interventions which may improve health related quality of life.
Biography
Jared is a senior Geriatric Physiotherapist, who has worked across public health services for 10+ years. His current roles are working in a Perioperative clinic for Older Persons, considering surgery and Community Therapy Services. He is passionate about promoting autonomy, independence and health for older adults.