The Geriatric Emergency Care Applied Research (GEAR) Network Approach: a Protocol to Advance Stakeholder Consensus and Research Priorities in Geriatrics and Dementia Care in the Emergency Department

Overview

Journal BMJ Open

Specialty General Medicine

Date 2022 Apr 23

PMID 35459682

Authors

Ula Hwang

Christopher Carpenter

Scott Dresden

Jeffrey Dussetschleger

Angela Gifford

Ly Hoang

Jesseca Leggett

Armin Nowroozpoor

Zachary Taylor

Manish Shah

Affiliations

Soon will be listed here.

Abstract

Introduction: Increasingly, older adults are turning to emergency departments (EDs) to address healthcare needs. To achieve these research demands, infrastructure is needed to both generate evidence of intervention impact and advance the development of implementation science, pragmatic trials evaluation and dissemination of findings from studies addressing the emergency care needs of older adults. The Geriatric Emergency Care Applied Research Network (https://gearnetwork.org) has been created in response to these scientific needs-to build a transdisciplinary infrastructure to support the research that will optimise emergency care for older adults and persons living with dementia.

Methods And Analysis: In this paper, we describe our approach to developing the GEAR Network infrastructure, the scoping reviews to identify research and clinical gaps and its use of consensus-driven research priorities with a transdisciplinary taskforce of stakeholders that includes patients and care partners. We describe how priority topic areas are ascertained, the process of conducting scoping reviews with integrated academic librarians performing standardised searches and providing quality control on reviews, input and support from the taskforce and conducting a large-scale consensus workshop to prioritise future research topics. The GEAR Network approach provides a framework and systematic approach to develop a research agenda and support research in geriatric emergency care.

Ethics And Dissemination: This is a systematic review of previously conducted research; accordingly, it does not constitute human subjects research needing ethics review. These reviews will be prepared as manuscripts and submitted for publication to peer-reviewed journals, and the results will be presented at conferences.Open Science Framework registered DOI: 10.17605/OSF.IO/6QRYX, 10.17605/OSF.IO/AKVZ8, 10.17605/OSF.IO/EPVR5, 10.17605/OSF.IO/VXPRS.

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References

Carpenter C, Heard K, Wilber S, Ginde A, Stiffler K, Gerson L . Research priorities for high-quality geriatric emergency care: medication management, screening, and prevention and functional assessment. Acad Emerg Med. 2011; 18(6):644-54. PMC: 3117251. DOI: 10.1111/j.1553-2712.2011.01092.x. View

Hammouda N, Carpenter C, Hung W, Lesser A, Nyamu S, Liu S . Moving the needle on fall prevention: A Geriatric Emergency Care Applied Research (GEAR) Network scoping review and consensus statement. Acad Emerg Med. 2021; 28(11):1214-1227. PMC: 8581064. DOI: 10.1111/acem.14279. View

Hwang U, Morrison R . The geriatric emergency department. J Am Geriatr Soc. 2007; 55(11):1873-6. DOI: 10.1111/j.1532-5415.2007.01400.x. View

Schardt C, Adams M, Owens T, Keitz S, Fontelo P . Utilization of the PICO framework to improve searching PubMed for clinical questions. BMC Med Inform Decis Mak. 2007; 7:16. PMC: 1904193. DOI: 10.1186/1472-6947-7-16. View

. Proceedings of the 8th Annual Conference on the Science of Dissemination and Implementation : Washington, DC, USA. 14-15 December 2015. Implement Sci. 2016; 11 Suppl 2:100. PMC: 4977475. DOI: 10.1186/s13012-016-0452-0. View

Ukkonen M, Jamsen E, Zeitlin R, Pauniaho S . Emergency department visits in older patients: a population-based survey. BMC Emerg Med. 2019; 19(1):20. PMC: 6391758. DOI: 10.1186/s12873-019-0236-3. View

Rethlefsen M, Farrell A, Trzasko L, Brigham T . Librarian co-authors correlated with higher quality reported search strategies in general internal medicine systematic reviews. J Clin Epidemiol. 2015; 68(6):617-26. DOI: 10.1016/j.jclinepi.2014.11.025. View

Hogan T, Olade T, Carpenter C . A profile of acute care in an aging America: snowball sample identification and characterization of United States geriatric emergency departments in 2013. Acad Emerg Med. 2014; 21(3):337-46. DOI: 10.1111/acem.12332. View

Schumacher J, Hirshon J, Magidson P, Chrisman M, Hogan T . Tracking the Rise of Geriatric Emergency Departments in the United States. J Appl Gerontol. 2018; 39(8):871-879. DOI: 10.1177/0733464818813030. View

10.

Gettel C, Voils C, Bristol A, Richardson L, Hogan T, Brody A . Care transitions and social needs: A Geriatric Emergency care Applied Research (GEAR) Network scoping review and consensus statement. Acad Emerg Med. 2021; 28(12):1430-1439. PMC: 8725618. DOI: 10.1111/acem.14360. View

11.

Carpenter C, Banerjee J, Keyes D, Eagles D, Schnitker L, Barbic D . Accuracy of Dementia Screening Instruments in Emergency Medicine: A Diagnostic Meta-analysis. Acad Emerg Med. 2018; 26(2):226-245. DOI: 10.1111/acem.13573. View

12.

Carpenter C, McFarland F, Avidan M, Berger M, Inouye S, Karlawish J . Impact of Cognitive Impairment Across Specialties: Summary of a Report From the U13 Conference Series. J Am Geriatr Soc. 2019; 67(10):2011-2017. PMC: 6800784. DOI: 10.1111/jgs.16093. View

13.

Kennedy M, Lesser A, Israni J, Liu S, Santangelo I, Tidwell N . Reach and Adoption of a Geriatric Emergency Department Accreditation Program in the United States. Ann Emerg Med. 2021; 79(4):367-373. PMC: 10015385. DOI: 10.1016/j.annemergmed.2021.06.013. View

14.

Kayser J, Morrow-Howell N, Rosen T, Skees S, Doering M, Clark S . Research priorities for elder abuse screening and intervention: A Geriatric Emergency Care Applied Research (GEAR) network scoping review and consensus statement. J Elder Abuse Negl. 2021; 33(2):123-144. PMC: 8204570. DOI: 10.1080/08946566.2021.1904313. View

15.

Carpenter C, Shah M, Hustey F, Heard K, Gerson L, Miller D . High yield research opportunities in geriatric emergency medicine: prehospital care, delirium, adverse drug events, and falls. J Gerontol A Biol Sci Med Sci. 2011; 66(7):775-83. PMC: 3143344. DOI: 10.1093/gerona/glr040. View

16.

Peters M, Godfrey C, Khalil H, McInerney P, Parker D, Soares C . Guidance for conducting systematic scoping reviews. Int J Evid Based Healthc. 2015; 13(3):141-6. DOI: 10.1097/XEB.0000000000000050. View

17.

Tricco A, Lillie E, Zarin W, OBrien K, Colquhoun H, Levac D . PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018; 169(7):467-473. DOI: 10.7326/M18-0850. View

18.

Tang N, Stein J, Hsia R, Maselli J, Gonzales R . Trends and characteristics of US emergency department visits, 1997-2007. JAMA. 2010; 304(6):664-70. PMC: 3123697. DOI: 10.1001/jama.2010.1112. View

19.

Sabir M, Breckman R, Meador R, Wethington E, Reid M, Pillemer K . The CITRA research-practice consensus-workshop model: exploring a new method of research translation in aging. Gerontologist. 2006; 46(6):833-9. DOI: 10.1093/geront/46.6.833. View

20.

Carpenter C, Hammouda N, Linton E, Doering M, Ohuabunwa U, Ko K . Delirium Prevention, Detection, and Treatment in Emergency Medicine Settings: A Geriatric Emergency Care Applied Research (GEAR) Network Scoping Review and Consensus Statement. Acad Emerg Med. 2020; 28(1):19-35. PMC: 7971946. DOI: 10.1111/acem.14166. View