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this system were used to coach physical activity among clinical
populations [1– 3].
Methods: Twelve adults aged above 65 used a smartphone, a
pedometer and a smartscale for a period of four weeks. Afterwards,
an interview was performed to assess the participants ’ subjective
experience regarding the use of the system. Well-being was assessed
with a set of questions on the daily experience of positive emotions.
The actual behavior was compared to the self-perception of physical
activity.
Results: Seven participants reported they became more active,
although objective data does not support this statement. Four parti-
cipants reported becoming more aware about their well-being
through the daily questions about experience of positive emotions.
In general, the participants were satisfied and would like to use such
system in their daily lives; participants recommended incorporation
of tips and warnings tailored to personal needs and capabilities.
Conclusions: Older adults are willing to use technology to monitor
their health and to coach them into healthier lifestyles. Daily life
interventions must be tailored to the individual needs and wishes,
instead of taking a one-size-fits-all approach. The results of this study
are transversal and assist in the design of interventions using mobile
technology in daily life.
References
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Hermens H. J. (2012). Do personalized feedback messages about
activity patterns stimulate patients with chronic low back pain
to change their activity behavior on a short term notice? Applied
Psychophysiology and Biofeedback, 37(2), 81–9. doi:
[2] Tabak M., Brusse-Keizer M., van der Valk P., Hermens H., &
Vollenbroek-Hutten M. (2014). A telehealth program for self-
management of COPD exacerbations and promotion of an active
lifestyle: A pilot randomized controlled trial. International Journal
of COPD, 9, 935–944. doi:
[3] Wolvers Md., Bruggeman-Everts F. Z., Van der Lee M. L., Van
de Schoot R., & Vollenbroek-Hutten M. M. (2015). Effectiveness,
Mediators, and Effect Predictors of Internet Interventions for
Chronic Cancer-Related Fatigue: The Design and an Analysis
Plan of a 3-Armed Randomized Controlled Trial. JMIR Research
Protocols, 4(2), e77. doi:
P-712
Caring for the caregiver
A. Cochofel 1, B. Filipe 2, I. Pecellin2. 1Unidade de Saúde Familiar Flor de
Lótus, Cacém, 2Unidade de Saúde Familiar Quinta da Prata, Borba,
Portugal.
Introduction: The informal caregiver helps the personwho is partially
or totally dependent on their activities of daily living (ADL). The
caregiver finds himself in the social network of informal support
and assumes this responsibility voluntarily or in an imposed way.
Objectives: Understanding the real impact on the lives of informal
caregivers and strategies that could minimize them.
Material and methods: Meta-analysis, systematic reviews and
randomized controlled trials research in the following scientific
databases: Scielo and ClinicalKey. These included articles written
in Portuguese, Spanish and English, published in the last five years,
using the following MESH terms: “Cuidador informal ” and “informal
caregiver ”.
Results: Of the 2124 initial results 474 articles were analyzed, 5 of
which met inclusion criteria. The articles showed that the main
impacts on the life of informal caregiver are: 1. Back pain overload;
2. Chronic stress related to high blood pressure; 3. Depression related
to the number of hours spent in the care of the geriatric person;
4. Interaction difficulties, which cause great emotional and psycho-
logical wear; 5. Scarcity of financial resources. These changes in the
caregiver ’s life end up having an important impact on the care
provided and the relationship established with the dependent elderly
person.
Discussion/conclusions: The activity of the informal caregiver
implies a significant physical, mental, social and economic overload,
for which we believe the creation of support programs could help
lighten this load. It is necessary to implement programs that integrate
multidisciplinary teams in order to provide specialized support to
caregivers.
P-713
Aged Residential Care Healthcare Implementation Project
(ARCHIP). A multidisciplinary team (MDT) intervention package
reduces emergency hospital presentations from Long Term
Care (LTC)
M.J. Connolly1,2, J.B. Broad1, M. Boyd1,2, X. Zhang1, D. Bramley2,
L.F. Johnson3, K. Bloomfield1,2. 1University of Auckland New Zealand,
2Waitemata District Health Board, 3Waitemata Primary Health
Organisation, Auckland, New Zealand
Introduction: The complexity of older people living in LTC facilities
poses challenges often leading to potentially avoidable Emergency
Department (ED) referrals. ARCHIP’ s aim was to evaluate an MDT
intervention supporting LTC facility staff to decrease potentially
avoidable resident ED admissions.
Methods: ARCHIP (conducted in 21 facilities [1,296 beds] with
previously-noted high ED referral rates) comprised clinical coaching
for LTC facility staff by gerontology nurse specialist (GNS) and MDT
(facility senior nurse, resident’s general practitioner, GNS, geriatrician,
pharmacist) review of selected high-risk residents’ care-plans. A
before-after repeated measures analysis of ED visits was conducted
for facilities pre- and post-intervention. The sample included ED
admissions 9 months before and 9 months after intervention
commencement (29-month period in total because of staggered
facility enrolment). Modelling adjusted for time trend, seasonality,
facility size, and cluster effect.
Results: ED admission rate ratio was 0.75 (95%C.I. 0.63,0.88, p-value
= 0.0008), a 25% reduction in ED presentations post-intervention.
A sensitivity model used a shorter, staggered time period centred on
intervention start (9 months pre-intervention and 9 months post-
intervention) for each facility, and a four-level categorical interven-
tion variable testing intervention effect over time. This showed a
24% reduction in ED presentations in months 1–3 post-intervention
(p-value = 0.07), 34% reduction in months 4–6 (p-value = 0.01), and
32% reduction in ED presentations in months 7–9 (p-value = 0.03).
When the higher rates for 3 months immediately pre-intervention
were modelled, ED presentation rates reverted to previous levels.
Key conclusions: GNS-led MDT outreach intervention decreases
avoidable ED admissions of high-risk residents from selected facilities.
P-714
Health Care of Older People hospital readmissions: a prospective
take
R. Cowan1, A. Blundell1, A. Ali1. 1Health Care of Older People, Nottingham
University Hospitals NHS Trust, United Kingdom
Introduction: The United Kingdom’s National Tariff Payment System
describes the 30 day readmission rule in which commissioners set
a threshold above which payment for emergency readmissions is
not reimbursed. Reasons for hospital readmission are complex and
multifactorial, with little evidence to support cost-effective ways of
preventing readmissions.
Methods: A prospective audit of emergency readmissions within
28 days from an inpatient stay under the Health Care of Older People
(HCOP) department was carried out. Demographic data for the
initial admission and readmission were collected for 122 readmission
episodes. The prospective approach enabled gathering of qualitative
data through case notes review and discussion with the multidiscip-
linary team and General Practitioner regarding events of the initial
admission and prior to readmission.
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S216