• Plos One · Jan 2016

    Randomized Controlled Trial

    Effects of Nurse-Led Multifactorial Care to Prevent Disability in Community-Living Older People: Cluster Randomized Trial.

    • Jacqueline J Suijker, Marjon van Rijn, Bianca M Buurman, Gerben Ter Riet, Eric P Moll van Charante, and Sophia E de Rooij.
    • Department of General Practice, Academic Medical Center, Amsterdam, The Netherlands.
    • Plos One. 2016 Jan 1; 11 (7): e0158714.

    BackgroundTo evaluate the effects of nurse-led multifactorial care to prevent disability in community-living older people.MethodsIn a cluster randomized trail, 11 practices (n = 1,209 participants) were randomized to the intervention group, and 13 practices (n = 1,074 participants) were randomized to the control group. Participants aged ≥ 70 years were at increased risk of functional decline based on a score ≥ 2 points on the Identification of Seniors at Risk- Primary Care, ISAR-PC. Participants in the intervention group received a systematic comprehensive geriatric assessment, and individually tailored multifactorial interventions coordinated by a trained community-care registered nurse (CCRN) with multiple follow-up home visits. The primary outcome was the participant's disability as measured by the modified Katz activities of daily living (ADL) index score (range 0-15) at one year follow-up. Secondary outcomes were health-related quality of life, hospitalization, and mortality.ResultsAt baseline, the median age was 82.7 years (IQR 77.0-87.1), the median modified Katz-ADL index score was 2 (IQR 1-5) points in the intervention group and 3 (IQR 1-5) points in the control group. The follow-up rate was 76.8% (n = 1753) after one year and was similar in both trial groups. The adjusted intervention effect on disability was -0.07 (95% confidence interval -0.22 to 0.07; p = 0.33). No intervention effects were found for the secondary outcomes.ConclusionsWe found no evidence that a one-year individualized multifactorial intervention program with nurse-led care coordination was better than the current primary care in community-living older people at increased risk of functional decline in The Netherlands.Trial RegistrationNetherlands Trial Register NTR2653.

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