The perception of the clinical relevance of the MDS-Home Care(C) tool by trainers in general practice in Belgium

Duyver, Corentin [UCL] Van Houdt, Sabine [KUL] De Lepeleire, Jan [KUL] Dory, Valérie [UCL] Degryse, Jean-Marie [UCL]

BACKGROUND: Comprehensive geriatric assessment has been advocated as an effective way to first identify multidimensional needs and second to establish priorities for organizing an individual health care plan for community-dwelling elderly. This paper reports on the perception of an internationally evaluated assessment system for use in community care programmes, the Minimal Data Set-Home Care (MDS-HC(c)), by a group of experienced GP trainers. OBJECTIVE: The primary study aim was to determine the perception of a standardized home care assessment system (MDS-HC(c)) by GP trainers in terms of acceptability, perceived clinical relevance, care planning empowerment and valorization of the GP. METHODS: Sixty-five first-year GP trainees were educated about the MDS-HC(c) and the use of a first version of an electronic interface. Each trainee included two elderly patients, based on strict inclusion criteria. Prior to the assessment, GP trainers and trainees were invited to complete together a basic medical record on the basis of their knowledge of the included patients. Next, the collected data, covering the multiple domains by MDS-HC(c), were introduced in the electronic interface by the trainee. Based on the collected data for each patient, a series of clinical assessment protocols (CAP's) were generated. Afterwards, these CAP's were critically discussed with the trainer. To investigate how the application of the MDS-HC(c) was perceived, a 21 Likert-type item scale was drawn up based on four dimensions regarding the tool. RESULTS: The perception questionnaire had a good internal consistency (Cronbach's alpha 0.93). The first version of the electronic interface was considered not 'user-friendly' enough and the introduction of data time-consuming. The perception of the GP's about the overall clinical relevance of the MDS-HC(c) was found to have little added value for the GP in the establishment of a personal management plan. CONCLUSIONS: Many developments in health care result in an increasing demand for a standardized home care assessment system. In Belgium, the federal public health service advised to promote the MDS-HC(c) for use in the community setting. In this study, it appears that its added value was not perceived by this sample of 37 experienced GP trainers as an empowering tool in term of management of the patient and valorization of the role of GP.