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Laying the foundation for a core set of the International Classification of Functioning, Disability and Health for community-dwelling adults aged 75 years and above in general practice: a study protocol
  1. Johanna Tomandl1,
  2. Stephanie Book2,
  3. Susann Gotthardt3,
  4. Stefan Heinmueller1,
  5. Elmar Graessel2,
  6. Ellen Freiberger3,
  7. Thomas Kuehlein1,
  8. Susann Hueber1,
  9. Stefanie Hoyer1
  1. 1 Institute of General Practice, Universitätsklinikum Erlangen/Chair of General Practice, Friedrich‐Alexander‐Universität Erlangen‐Nürnberg, Erlangen, Germany
  2. 2 Center for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
  3. 3 Institute for Biomedicine of Ageing, Department of Inner Medicine, Friedrich‐Alexander‐ Universität Erlangen‐Nürnberg, Nuremberg, Germany
  1. Correspondence to Ms Johanna Tomandl; johanna.tomandl{at}uk-erlangen.de

Abstract

Introduction With the medical focus on disease, the problem of overdiagnosis inevitably increases with ageing. Considering the functional health of patients might help to discriminate between necessary and unnecessary medicine. The International Classification of Functioning, Disability and Health (ICF) is an internationally recognised tool for describing functional health. However, it is too detailed to be used in primary care practices. Consequently, the aim of this study is to identify relevant codes for an ICF core set for community-dwelling older adults (75 years and above) in primary care.

Methods and analysis The study will follow the methodology proposed by the ICF Research Branch to identify relevant concepts from different perspectives: (1) Research perspective: A systematic review of studies focusing on functional health in old age will be conducted in different databases. Relevant concepts will be extracted from the publications. (2) Patients’ perspective: Relevant areas of functioning and disability will be identified conducting qualitative interviews and focus groups with community-dwelling older persons. The interviews will be transcribed verbatim and analysed using the documentary method of interpretation. (3) Experts’ perspective: An online survey with open-ended questions will be conducted. Answers will be analysed using the qualitative content analysis of Mayring. (4) Clinical perspective: A cross-sectional empirical study will be performed to assess the health status of community-dwelling older adults using the extended ICF checklist and other measurement tools.

Relevant concepts identified in each study will be linked to ICF categories resulting in four preliminary core sets.

Ethics and dissemination Ethical approval for the study was obtained (90_17B). All participants will provide written informed consent. Data will be pseudonymised for analysis. Results will be disseminated by conference presentations and journal publications.

Trial registration number Projektdatenbank Versorgungsforschung Deutschland: VfD_17_003833,Clinicaltrials.gov: NCT03384732 and PROSPERO: CRD42017067784.

  • community-dwelling older persons
  • geriatric
  • icf core set
  • overdiagnosis
  • patient-centred medicine
  • primary care

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • SHu and SHo contributed equally.

  • Contributors JT: project administration and conduct of the systematic review and the qualitative study, partaking empirical study and experts’ survey, writing original draft. SB: project administration and conduct of the empirical study, partaking systematic review, qualitative study and empirical study, review and editing of the draft. SG: project administration and conduct of the experts’ survey, partaking systematic review, qualitative study and experts’ survey, review and editing of the draft. SH: partaking systematic review, review and editing of the draft. TK: study design, supervision in all four studies, review and editing of the draft. EF: study design, supervision in all four studies, partaking systematic review, review and editing of the draft. EG: study design, supervision in all four studies, review and editing of the draft. SHu: study design, supervision, provision of support and important suggestions for the overall project, review and editing of the draft. SHo: supervision in all four studies, provision of support and important suggestions for the overall project, review and editing of the draft. All authors have read and approved the final version of the manuscript. SHu and SHo contributed equally to this work.

  • Funding This study was funded by the German Federal Ministry of Education and Research (BMBF), grant number: 01GY1605.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval This study was approved by the institutional review board (Ethikkommission der Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Ethics Committee of the University of Erlangen-Nuremberg: Number 90_17 B).

  • Provenance and peer review Not commissioned; peer reviewed for ethical and funding approval prior to submission.

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