Oral Presentation Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2026

Comprehensive geriatric assessment for frail older people living with chronic kidney disease – a cluster randomised controlled trial (the GOAL trial) (#40)

Benignus Logan 1 , Andrea K Viecelli 1 , David W Johnson 1 , Tracy Comans 1 , Emily Gordon 1 , Len Gray 1 , Carmel Hawley 1 , Laura Hickey 1 , Monika Janda 1 , Allison Jaure 2 , Matthew Jose 3 , Charani Kiriwandeniya 1 , Misa Matsuyama 1 , Gabor Mihala 1 , Kim-Huong Nguyen 1 , Elaine Pascoe 1 , Peta-Anne Paul-Brent 1 , Jason Pole 1 , Kevan Polkinghorne 4 , Constance Pond 5 , Rajesh Raj 6 , Donna Reidlinger 1 , Nicole Scholes-Robertson 2 , Andrea Valks 1 , Germaine Wong 2 , Ruth Eleanor Hubbard 1 , on behalf of The GOAL Trial Investigators 1
  1. University of Queensland, Brisbane
  2. Sydney School of Public Health, The University of Sydney, Sydney
  3. University of Tasmania, Hobart
  4. Monash University, Melbourne
  5. Wicking Dementia Research and Education Centre, Hobart
  6. Launceston General Hospital, Launceston

Aims: Comprehensive geriatric assessment (CGA) benefits older people but has not been evaluated in chronic kidney disease (CKD). Frail older people with CKD have complex care needs. The GOAL trial examined whether CGA helped this population attain their goals.

 

Methods: In this cluster randomised controlled trial, kidney outpatient centres were assigned (1:1) to provide CGA plus usual care or usual care alone for frail older people with CKD (Frailty Index [FI] >0.25; aged ≥65 years, or ≥55 years for First Nations people; CKD stage 3–5/5D [eGFR≤59mL/min/1.73m2]). The primary outcome was Goal Attainment Scaling (GAS) at 3 months, analysed using mixed-effects linear regression. Secondary outcomes were quality of life, FI, mortality, hospitalisations, and residential aged care admissions. Analyses were intention-to-treat at cluster and participant levels.

 

Results: A total of 240 participants were recruited (mean age 76.9 years [SD 6.6]; median FI 0.39 [IQR 0.33–0.47]); 114 were from 7 intervention clusters and 126 from 8 control clusters. Retention was challenging during COVID, with 19% (22/114) not receiving CGA within 14 days. At 3 months, GAS scores did not differ significantly between intervention and control groups (45.2 [SD 11.7] vs 43.7 [SD 10.9]; mean difference 1.54, 95% CI -3.13–6.20; p=0.47). No significant differences were observed in secondary outcomes. An average 2.5-day reduction in hospital stay over 12 months was noted in the intervention group (p=0.54).

 

Conclusion: In frail older people with CKD, outpatient CGA did not improve individualised goal attainment.