Start low, go slow, but look far: the case of geriatric medicine in Balkan countries

• Published in: European geriatric medicine 2020-10, Vol.11 (5), p.869-878
• Main Authors: Kotsani, Marina, Ellul, John, Bahat, Gülistan, Bogdanovic, Nenad, Burazeri, Genc, Erceg, Predrag, Petreska-Zovic, Biljana, Prada, Gabriel Ioan, Smyrnakis, Emmanouil, Veninšek, Gregor, Zamboulis, Chrysanthos, Martin, Finbarr C., Petrovic, Mirko, Benetos, Athanase
• Format: Article
• Language: English
• Subjects: Geriatrics/Gerontology; Internal Medicine; Medicin och hälsovetenskap; Medicine; Medicine & Public Health; Special Article
• ISSN: 1878-7657; 1878-7649; 1878-7657
• DOI: 10.1007/s41999-020-00350-x

Key summary points Aim To briefly present the current situation regarding Geriatric Medicine in Balkan countries and discuss possible perspectives of development by exchange and interaction with countries with more developed Geriatric Medicine. Findings Balkan countries seem to encounter similar difficulties and share common challenges regarding under- and post-graduate education in geriatric medicine, accessibility to comprehensive geriatric assessment and response to special needs of older people in various clinical settings. Proposed solutions need to be pragmatic, effective, applicable in harmony with available services and adjusted to each country’s special context. Message InterEuropean networking, cooperation among countries under the auspices of EuGMS, and suitable application of experience from countries with developed Geriatrics, could contribute to the development of Geriatric Medicine in Balkan countries as well. Purpose To present an insight of the situation of geriatric medicine in Balkan countries, as it was presented in the context of the 2nd pre-congress seminar of the 16th European Geriatric Medicine Society (EuGMS) Congress Athens 2021. Methods Representatives from 8 Balkan countries (Albania, Croatia, Greece, Republic of North Macedonia, Romania, Serbia, Slovenia, Turkey) answered 3 questions to reflect the state of geriatric medicine in their country: education on geriatrics; systems/methods for assessment of functional status and frailty; pre-operative risk assessment. An open discussion followed. Results Undergraduate education in geriatric medicine seems underestimated in medical faculties of Balkan countries, whereas a high heterogeneity is observed at a post-graduate level. Only a few Balkan countries have geriatric medicine as a recognized medical specialty or subspecialty. Functional status and frailty are only sporadically assessed, and pre-operative risk assessment is very rarely performed with a geriatric focus. Scarcity of expertise and structures relevant to geriatric medicine seems to be common. Developing a training curriculum and geriatrics-related structures are two interconnected aspects. Cooperation among physicians and multidisciplinary teams are essential for the practice of geriatric medicine. A functional geriatric network is eventually necessary and ambulatory geriatric expertise is probably a feasible and clinically relevant starting point. Providing pragmatic solutions to the pressing challenges in variable cli