OBJECTIVES: Because preventing disability and falls in older adults is a national priority, a randomized controlled trial was conducted to test a multicomponent intervention program. METHODS:From a random sample of health maintenance organization (HMO) enrollees 65 years and older, 1559 ambulatory seniors were randomized to one of three groups: a nurse assessment visit and follow-up interventions targeting risk factors for disability and falls (group 1, n = 635); a general health promotion nurse visit (group 2, n = 317); and usual care (group 3, n = 607). Data collection consisted of a baseline and two annual follow-up surveys. RESULTS: After 1 year, group 1 subjects reported a significantly lower incidence of declining functional status and a significantly lower incidence of falls than group 3 subjects. Group 2 subjects had intermediate levels of most outcomes. After 2 years of follow-up, the differences narrowed. CONCLUSIONS: The results suggest that a modest, one-time prevention program appeared to confer short-term health benefits on ambulatory HMO enrollees, although benefits diminished by the second year of follow-up. The mechanisms by which the intervention may have improved outcomes require further investigation.
RCT Entities:
OBJECTIVES: Because preventing disability and falls in older adults is a national priority, a randomized controlled trial was conducted to test a multicomponent intervention program. METHODS: From a random sample of health maintenance organization (HMO) enrollees 65 years and older, 1559 ambulatory seniors were randomized to one of three groups: a nurse assessment visit and follow-up interventions targeting risk factors for disability and falls (group 1, n = 635); a general health promotion nurse visit (group 2, n = 317); and usual care (group 3, n = 607). Data collection consisted of a baseline and two annual follow-up surveys. RESULTS: After 1 year, group 1 subjects reported a significantly lower incidence of declining functional status and a significantly lower incidence of falls than group 3 subjects. Group 2 subjects had intermediate levels of most outcomes. After 2 years of follow-up, the differences narrowed. CONCLUSIONS: The results suggest that a modest, one-time prevention program appeared to confer short-term health benefits on ambulatory HMO enrollees, although benefits diminished by the second year of follow-up. The mechanisms by which the intervention may have improved outcomes require further investigation.
Authors: D B Hogan; F A MacDonald; J Betts; S Bricker; E M Ebly; B Delarue; T S Fung; C Harbidge; M Hunter; C J Maxwell; B Metcalf Journal: CMAJ Date: 2001-09-04 Impact factor: 8.262
Authors: A Oakley; M F Dawson; J Holland; S Arnold; C Cryer; Y Doyle; J Rice; C R Hodgson; A Sowden; T Sheldon; D Fullerton; A M Glenny; A Eastwood Journal: Qual Health Care Date: 1996-12
Authors: Meghann Moore; Barbara Williams; Sally Ragsdale; James P Logerfo; J Richard Goss; Astrid B Schreuder; Elizabeth A Phelan Journal: J Am Geriatr Soc Date: 2010-02 Impact factor: 5.562
Authors: Iveris L Martinez; Kevin Frick; Thomas A Glass; Michelle Carlson; Elizabeth Tanner; Michelle Ricks; Linda P Fried Journal: J Urban Health Date: 2006-09 Impact factor: 3.671