August 05, 2020
An innovative medicalization program at four nursing homes in Spain improved rates of survival or optimal palliative care, and reduced hospital referrals, during a local COVID-19 outbreak in March 2020. Researchers published their findings online in The Journals of Gerontology: Series A.
The coordinated effort aimed to offer medically rigorous but humanistic care to residents with COVID-19 within their nursing homes to minimize community spread and hospital saturation.
“This medicalization program virtuously gathered substantial hospital and primary care resources as well as internal medicine, primary care, and epidemiology professionals during an intense but short time-period,” researchers wrote.
Preparations required the establishment of 10 key processes and interventions, including the provision of medical equipment, universal COVID-19 testing, and the separation of “clean” and “contaminated” areas.
Among 59.5% of residents infected with COVID-19 during the outbreak, 97% achieved the composite endpoint of survival or optimal palliative care, compared with 77% diagnosed before the medicalization program, according to the study. Rates of survival and hospital referral after the program’s start were 83.7% and 17%, respectively, compared with 72.5% and 29% before the program.
The endpoint of survival or optimal palliative care was independently associated with the medicalization program, researchers reported. Survival in residents treated in the medicalization program was associated with the use of any antiviral treatment.
“A coordinated on-site medicalization program of nursing homes with COVID-19 outbreaks achieved a higher survival or optimal palliative care rate, and a reduction in referrals to hospital, thus ensuring rigorous but also humanistic and gentle care to residents,” researchers concluded.
Bernabeu-Wittel M, Ternero-Vega JE, Nieto-Martín MD, et al. Effectiveness of a On-Site Medicalization Program for Nursing Homes with COVID-19 Outbreaks [published online ahead of print, 2020 Aug 1]. J Gerontol A Biol Sci Med Sci. 2020;glaa192. doi:10.1093/gerona/glaa192