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2021; Volume 22, No 12, December

Integrated Care for Older People (ICOPE):
A community assessment and management app

By Dr. Romayne Gallagher
IAHPC App Reviewer

On the 2019 Day of Older Persons, the World Health Organization (WHO) launched the free Integrated Care for Older People (ICOPE) handbook app to provide community assessment of intrinsic capacities needed to function independently. Based on WHO guidelines of care, the app provides assessment of six aspects of function: cognitive, hearing, visual, mood, nutrition, and mobility. If deficits are identified, it provides a care pathway of practical recommendations to restore or maintain function. The tool is evidence-based1 and a community setting pilot study2 found it useful in identifying those with deficits. Outcome evidence is the next step.

ICOPE app is designed for “health and social workers” to use in community settings, but trained volunteers and, potentially, caregivers could also use it. The app, available in eight languages, walks you through the test of function: cognitive (clock drawing, orientation, memory), hearing (a separate app), visual, mood (geriatric depression scale), nutrition (weight loss) and mobility (modified “sit to stand” test). The app design enforces a full assessment; it does not let you proceed to the next step without completing each intrinsic function. The full screening takes about 10-15 minutes and multiple interventions are suggested if deficits are detected. Interventions committed to by the patient and caregiver can be printed as a pdf or sent via text or email. This record of the visit makes an excellent instructions reminder for use at home and is also useful for future visits as a comparison. It was both amusing and sobering inventing my own deficits to see what the care pathways offered.

The app seems trouble free, but is an enormous file for Apple users. It is a 37MB download at the Apple site and requires a further 18MB for the WHO hearing app, without which you cannot complete the assessment. For Android phones, Google Play has a recent integration of the two apps as a 32MB file, so hopefully changes will come to iOS soon. The app is downloadable to a Microsoft or Mac computer, making it useful for storage of assessments.

While the enforcing nature of the app design is helpful in achieving a repeatable standardized assessment, it does not allow the user the ability to explore and learn from the app without actually doing an assessment. I believe an option to view content without an assessment would increase its usefulness as an educational tool.

Anyone who works with older adults will find it a useful assessment tool for the office or home visits. If your holiday celebrations desperately need distraction, you can volunteer to check intrinsic functions!

References
  1. Takeda C, Guyonnet S, Sumi Y, Vellas B, Araujo de Carvalho I. Integrated Care for Older People and the Implementation in the INSPIRE Care Cohort. J Prev Alzheimers Dis 2020; 7(2): 70-74. DOI: 10.14283/jpad.2020.8
  2. Ma L, Chhetri J, Zhang Y, Liu P, Chen Y, Li Y, Chan P. Integrated Care for Older People Screening Tool for Measuring Intrinsic Capacity: Preliminary findings from ICOPE pilot in China. Frontiers Med 2020; 7: 852. DOI: 10.3389/fmed.2020.576079

Note for app creators
If you would like your app reviewed, please contact Alison Ramsey with the app name, a link to the app, and a brief description.

Note for authors
If you wish to have your book reviewed, please send an email with the book title, a brief description, and the ISBN to: Alison Ramsey. Do not ship hard copies to the IAHPC office.

NB: Review copies become the property of IAHPC and are not returned to the author. Only books related to palliative care that have been approved and have an ISBN will be reviewed. Due to the large number of requests, we cannot provide exact dates of when books will be reviewed.

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