Table 3.

Lessons learned and considerations for NGA implementing into routine clinical practice

Patients’ involvement and potential benefits • Clear communication of goals and outcomes (and interpretation) of tests • Consider the burden for patients individually, pay attention to results that might be confrontational • Spending 45–90 min in total to complete the NGA is acceptable and feasible • Repeated measurements to assess progression and to identify the need for additional supportive interventions • Caregivers can provide important information about patients’ situation at home

Selecting the right test set • Legibility and masked illiteracy can be important barriers • Adaptation of CGA into a smaller set for nephrology (NGA) is possible and feasible • Different instruments are suitable for usage in routine clinical practice, as long as all geriatric domains (i.e. somatic, social, functional and cognitive) are covered • Uniform implementation of NGA is necessary in response to the need for scientific evidence of geriatric measures on outcomes to predict individual progress of the disease.

Sufficient expertise and multidisciplinary cooperation • Collaboration between nephrology and geriatrics departments is of utmost importance to provide complementary patient care • Multidisciplinary team meetings are key to success • Assessment of geriatric domains can be done by either the nephrology and geriatrics department, once professionals are trained and experienced • Barriers for successful cooperation between the geriatric and nephrology department include: apprehension among nephrologists about loss of span of control, sparse knowledge and use of geriatric tools, and a high turnover of doctors

Supporting structures • Sufficient management support providing essential resources (e.g. time and money) for innovations • Securing the appropriate workforce, especially the availability of geriatricians • Value of NGA should be proven, resulting in evidence and directive guidelines