Literature DB >> 26957377

Multicomponent Program to Reduce Functional Decline in Frail Elderly People: A Cluster Controlled Trial.

Franca G H Ruikes1, Sytse U Zuidema2, Reinier P Akkermans2, Willem J J Assendelft2, Henk J Schers2, Raymond T C M Koopmans2.   

Abstract

BACKGROUND: The increasing number of community-dwelling frail elderly people poses a challenge to general practice. We evaluated the effectiveness of a general practitioner-led extensive, multicomponent program integrating cure, care, and welfare for the prevention of functional decline.
METHODS: We performed a cluster controlled trial in 12 general practices in Nijmegen, the Netherlands. Community-dwelling frail elderly people aged ≥70 years were identified with the EASY-Care two-step older persons screening instrument. In 6 general practices, 287 frail elderly received care according to the CareWell primary care program. This consisted of proactive care planning, case management, medication reviews, and multidisciplinary team meetings with a general practitioner, practice and/or community nurse, elderly care physician, and social worker. In another 6 general practices, 249 participants received care as usual. The primary outcome was independence in functioning during (instrumental) activities of daily living (Katz-15 index). Secondary outcomes were quality of life [EuroQol (EQ5D+C) instrument], mental health and health-related social functioning (36-item RAND Short Form survey instrument), institutionalization, hospitalization, and mortality. Outcomes were assessed at baseline and at 12 months, and were analyzed with linear mixed-model analyses.
RESULTS: A total of 204 participants (71.1%) in the intervention group and 165 participants (66.3%) in the control group completed the study. No differences between groups regarding independence in functioning and secondary outcomes were found.
CONCLUSION: We found no evidence for the effectiveness of a multifaceted integrated care program in the prevention of adverse outcomes in community-dwelling frail elderly people. Large-scale implementation of this program is not advocated. © Copyright 2016 by the American Board of Family Medicine.

Entities:  

Keywords:  Aging; Delivery of Health Care; Frail Elderly; Geriatric Assessment; Geriatrics; Interdisciplinary Health Team; Primary Health Care

Mesh：

Year:  2016        PMID： 26957377     DOI： 10.3122/jabfm.2016.02.150214

Source DB:  PubMed          Journal:  J Am Board Fam Med        ISSN： 1557-2625            Impact factor:   2.657


  19 in total

Review 1.  Comprehensive Geriatric Assessment for community-dwelling, high-risk, frail, older people.

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2.  Validity of the EASYCare Standard 2010 assessment instrument for self-assessment of health, independence, and well-being of older people living at home in Poland.

Authors:  Sławomir Tobis; Krystyna Jaracz; Dorota Talarska; Sylwia Kropińska; Ewa Zasadzka; Mariola Pawlaczyk; Katarzyna Wieczorowska-Tobis; Ian Philp; Aleksandra Suwalska
Journal:  Eur J Ageing       Date:  2017-04-03

3.  Implementation of integrated geriatric care at a German hospital: a case study to understand when and why beneficial outcomes can be achieved.

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4.  Efficacy of multidomain interventions to improve physical frailty, depression and cognition: data from cluster-randomized controlled trials.

Authors:  Liang-Kung Chen; An-Chun Hwang; Wei-Ju Lee; Li-Ning Peng; Ming-Hsien Lin; David L Neil; Shu-Fang Shih; Ching-Hui Loh; Shu-Ti Chiou
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5.  Frailty assessment in primary health care and its association with unplanned secondary care use: a rapid review.

Authors:  Ben R Davies; Helen Baxter; James Rooney; Phillip Simons; Ann Sephton; Sarah Purdy; Alyson L Huntley
Journal:  BJGP Open       Date:  2018-04-10

6.  Integrated Care for Frail Elderly: A Qualitative Study of a Promising Approach in The Netherlands.

Authors:  Maaike Hoedemakers; Fenna Ruby Marie Leijten; Willemijn Looman; Thomas Czypionka; Markus Kraus; Hanneke Donkers; Esther van den Hende-Wijnands; Nicole M A van den Broek; Maureen Rutten-van Mölken
Journal:  Int J Integr Care       Date:  2019-09-03       Impact factor: 5.120

7.  Explaining discrepancies in self-reported quality of life in frail older people: a mixed-methods study.

Authors:  Anne van der Vorst; G A Rixt Zijlstra; Nico De Witte; Ruth G M Vogel; Jos M G A Schols; Gertrudis I J M Kempen
Journal:  BMC Geriatr       Date:  2017-10-26       Impact factor: 3.921

8.  Cost-effectiveness of a multicomponent primary care program targeting frail elderly people.

Authors:  Franca G H Ruikes; Eddy M Adang; Willem J J Assendelft; Henk J Schers; Raymond T C M Koopmans; Sytse U Zuidema
Journal:  BMC Fam Pract       Date:  2018-05-16       Impact factor: 2.497

9.  Skill mix change between general practitioners, nurse practitioners, physician assistants and nurses in primary healthcare for older people: a qualitative study.

Authors:  Marleen H Lovink; Anneke J A H van Vught; Anke Persoon; Lisette Schoonhoven; Raymond T C M Koopmans; Miranda G H Laurant
Journal:  BMC Fam Pract       Date:  2018-05-02       Impact factor: 2.497

Review 10.  What works in implementation of integrated care programs for older adults with complex needs? A realist review.

Authors:  Maritt Kirst; Jennifer Im; Tim Burns; G Ross Baker; Jodeme Goldhar; Patricia O'Campo; Anne Wojtak; Walter P Wodchis
Journal:  Int J Qual Health Care       Date:  2017-10-01       Impact factor: 2.038
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