PURPOSE: Care for older patients in primary care is currently reactive, fragmented, and time consuming. An innovative structured and proactive primary care program (U-CARE) has been developed to preserve physical functioning and enhance quality of life of frail older people. This study describes in detail the development process of the U-CARE program to allow its replication. METHODS: The framework of the Medical Research Council (MRC) for the development and evaluation of complex interventions was used as a theoretical guide for the design of the U-CARE program. An extended stepwise multimethod procedure was used to develop U-CARE. A team of researchers, general practitioners, registered practice nurses, experts, and an independent panel of older persons was involved in the development process to increase its feasibility in clinical practice. A systematic review of the literature and of relevant guidelines, combined with clinical practice experience and expert opinion, was used for the development of the intervention. FINDINGS: Based on predefined potentially effective guiding components, the U-CARE program comprises three steps: a frailty assessment, a comprehensive geriatric assessment at home followed by a tailor-made care plan, and multiple follow-up visits. Evidence-based care plans were developed for 11 geriatric conditions. The feasibility in clinical practice was tested and approved by experienced registered practice nurses. CONCLUSIONS: Using the MRC Framework, a detailed description of the development process of the innovative U-CARE program is provided, which is often missing in reports of complex intervention trials. Based on our feasibility-pilot study, the general practitioners and the registered practice nurses indicated that the U-CARE intervention is feasible in clinical practice. CLINICAL RELEVANCES: The U-CARE program consists of promising components and has the potential to improve the care of older patients.
RCT Entities:
PURPOSE: Care for older patients in primary care is currently reactive, fragmented, and time consuming. An innovative structured and proactive primary care program (U-CARE) has been developed to preserve physical functioning and enhance quality of life of frail older people. This study describes in detail the development process of the U-CARE program to allow its replication. METHODS: The framework of the Medical Research Council (MRC) for the development and evaluation of complex interventions was used as a theoretical guide for the design of the U-CARE program. An extended stepwise multimethod procedure was used to develop U-CARE. A team of researchers, general practitioners, registered practice nurses, experts, and an independent panel of older persons was involved in the development process to increase its feasibility in clinical practice. A systematic review of the literature and of relevant guidelines, combined with clinical practice experience and expert opinion, was used for the development of the intervention. FINDINGS: Based on predefined potentially effective guiding components, the U-CARE program comprises three steps: a frailty assessment, a comprehensive geriatric assessment at home followed by a tailor-made care plan, and multiple follow-up visits. Evidence-based care plans were developed for 11 geriatric conditions. The feasibility in clinical practice was tested and approved by experienced registered practice nurses. CONCLUSIONS: Using the MRC Framework, a detailed description of the development process of the innovative U-CARE program is provided, which is often missing in reports of complex intervention trials. Based on our feasibility-pilot study, the general practitioners and the registered practice nurses indicated that the U-CARE intervention is feasible in clinical practice. CLINICAL RELEVANCES: The U-CARE program consists of promising components and has the potential to improve the care of older patients.
Authors: Mandy M N Stijnen; Maria W J Jansen; Inge G P Duimel-Peeters; Hubertus J M Vrijhoef Journal: BMC Fam Pract Date: 2014-10-25 Impact factor: 2.497
Authors: Olivia Yip; Evelyn Huber; Samuel Stenz; Leah L Zullig; Andreas Zeller; Sabina M De Geest; Mieke Deschodt Journal: Int J Integr Care Date: 2021-04-23 Impact factor: 5.120
Authors: Hugo M Smeets; Marlous F Kortekaas; Frans H Rutten; Michiel L Bots; Willem van der Kraan; Gerard Daggelders; Hanneke Smits-Pelser; Charles W Helsper; Arno W Hoes; Niek J de Wit Journal: BMC Health Serv Res Date: 2018-09-25 Impact factor: 2.655