- Navarrabiomed, which leads this transnational cooperation project, presents its partners the Navarre model for care of hospitalized elderly people at the launch meeting of PreDisc.
The partners of the PreDisc project met on Friday 15 March at Navarrabiomed to launch this transnational collaboration initiative, co-financed by ERDF funds through the Sudoe programme. Its aim is to prevent disability in older people by promoting regular physical activity during and after periods of hospitalization. This requires the prescription of a personalized training program during hospitalization and its continuation after discharge, with follow-up by Primary Care and thanks to the development of an innovative eHealth tool. The project also includes a multicenter clinical trial to generate scientific evidence and promote the integration of these programs into routine clinical practice. The presence of the partnership in Pamplona has been used to organize a visit to the geriatrics service of the HUN and present the Navarrese model of care for hospitalized elderly people.
PreDisc has a total budget of 1,288,550 euros, 75% co-financed by the Interreg Sudoe programme, which supports regional development in south-west Europe by helping to promote transnational projects through the European Regional Development Fund (ERDF). This programme promotes cooperation to solve problems common to the regions of south-western Europe.
The consortium of the project is led by the biomedical research center Navarrabiomed – Fundación Miguel Servet and has the participation of Instituto de Investigación Sanitaria de Navarra (IdiSNA), Atención Primaria del Servicio Navarro de Salud – Osasunbidea (SNS-O), University of Deusto (Bizkaia, Euskadi), Centre Hospitalier Universitaire de Toulouse Pôle Gériatrie (Occitania), Hospital Distrital da Figueira da Foz, EPE (Coimbra, Central Region) and Servei Andorrà d’Atenció Sanitària (Andorra), supported in turn by 9 public and private bodies from South-West Europe participating as partners.
Model of care for hospitalized elderly people in Navarra
Following the institutional event attended by the Health Counsellor of the Government of Navarra, Fernando Domínguez, the members visited the gym of the geriatrics service of the HUN, to know the model of care for hospitalized elderly people in Navarra and the impact that physical activity has on hospitalized elderly people.
Personalized physical activity prescription during the hospitalization period is being progressively integrated into the hospital system to prevent the functional impairment associated with hospitalization, It has not yet been fully integrated into routine clinical practice. “The aim is to give priority to functional recovery, thanks to an individualized training programme that makes it possible to shorten hospital stays and avoid the disability that may arise during hospitalizations. This new model of care allows a more integral approach to older people and takes us away from a model that is more focused on the disease than on the patient”, explains Nicolás Martinez Velilla, responsible for the Geriatrics and Active Aging Unit (INGEA) of Navarrabiomed, head of the geriatrics department at HUN and principal investigator of the PreDisc project.
It should be remembered that the demographic situation in the countries of the SUDOE territory, as in all of Europe, is characterized by a progressive ageing of the population, with a life expectancy around 83-84 years. This phenomenon poses challenges in terms of health care and long-term care. To address these challenges, comprehensive strategies are needed that promote active ageing, prevent disability, ensure universal accessibility and adapt services to the needs of older people. In this sense geriatric care during the hospitalization period is crucial in the life course of these/her patients. In 2012, an observational prospective study was conducted in patients over 75 years of age admitted to the Geriatrics Service of Navarra to assess the impact of bedding on their functionality. It was found that 48.4% of the patients suffered functional impairment at admission, and 38.7% continued to suffer this impairment upon discharge. The average bedtime was 19.7 hours per day, and 58.1% were bedtime 20 hours per day. The degree of bedding was associated with functional deterioration and mortality, suggesting the need for interventions to improve patient care.
A randomized clinical study conducted in 2019, also at the HUN, investigated the impact of an individualized exercise intervention on very elderly people during acute hospitalization. Randomized 370 patients to exercise or control groups. The main results showed that the exercise group experienced significant improvements in functional capacity, cognitive state, mood and quality of life compared to the control group. In addition, no adverse effects were observed associated with exercise intervention, suggesting that it is safe and effective to reverse the functional impairment related to hospitalization.
In order to integrate physical exercise into routine clinical practice, it is necessary to generate more scientific evidence through a multicenter clinical trial to be carried out within the framework of the PreDisc project. In this case, the randomized multicenter trial will be international and will involve the HUN, the CHU Toulouse, the Hospital Distrital da Figueira da Foz and the Hospital Nuestra Señora de Meritxell of Andorra. It aims to generate more scientific evidence and to integrate personalized physical activity programs into the usual clinical practice at hospital level.
From hospital to rural areas
In addition, to prevent disability in the longer term and improve the quality of life of older people in their daily lives, the PreDisc project proposes to continue this physical exercise program initiated in the hospital after discharge from hospital, Thanks to a follow-up by Primary Care and the development of an innovative eHealth tool.
And beyond the patient care in the health field, PreDisc also focuses its scope of action to promote active ageing, especially in rural areas, through the development of technological tools, training of healthcare personnel, Home visits and events in rural communities should reduce unnecessary hospital admissions.