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, Sophia E. de Rooij

Research output: Contribution to journalArticleAcademicpeer-review

16 Citations (Scopus)
2 Downloads (Pure)

Abstract

BACKGROUND: To evaluate the effects of nurse-led multifactorial care to prevent disability in community-living older people.

METHODS: In 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.

RESULTS: At 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.

CONCLUSIONS: We 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 REGISTRATION: Netherlands Trial Register NTR2653.

Original languageEnglish
Number of pages18
JournalPLoS ONE
Volume11
Issue number7
DOIs
Publication statusPublished - 26 Jul 2016
Externally publishedYes

Fingerprint Dive into the research topics of 'Effects of nurse-led multifactorial care to prevent disability in community-living older people. cluster randomized trial'. Together they form a unique fingerprint.

Cite this