Prevention of Adverse Health Trajectories in a Vulnerable Elderly Population Through Nurse Home Visits: A Randomized Controlled Trial [ISRCTN05358495].
OBJECTIVE: Can indicative prevention of home-visiting nurses be effective when targeted at a frail senior population using multidimensional geriatric assessments and personalized care plans? METHODS: We performed an individually randomized controlled trial in 33 blinded primary care practices over 1...
| Publicado en: | Journals of Gerontology Series A: Biological Sciences & Medical Sciences Vol. 65A; no. 7; pp. 734 - 743 |
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| Autores principales: | , , , , , |
| Formato: | research randomized controlled trial Journal Article |
| Publicado: |
Oxford University Press / USA
Jul2010
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105027973&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105027973 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10795006 JGA jtl: Journals of Gerontology Series A: Biological Sciences & Medical Sciences issn: 10795006 maglogo: N pubinfo: dt: Jul2010 vid: 65A iid: 7 pid: 622 pub: Oxford University Press / USA artinfo: ui: 105027973 51493091 51493091 10.1093/gerona/glq037 NLM20457579 105027973 ppf: 734 ppct: 9 formats: tig: atl: Prevention of Adverse Health Trajectories in a Vulnerable Elderly Population Through Nurse Home Visits: A Randomized Controlled Trial [ISRCTN05358495]. aug: au: van Hout HP Jansen AP van Marwijk HW Pronk M Frijters DF Nijpels G affil: Department of General Practice, EMGO Institute, VU University Medical Center Amsterdam, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. hpj.vanhout@vumc.nl. sug: subj: Health Services for Older Persons Home Nursing Activities of Daily Living Aged, 80 and Over Female Frail Elderly Geriatric Assessment Health Status Hospitalization Human Institutionalization Male Mortality Outcome Assessment Risk Factors Socioeconomic Factors Randomized Controlled Trials Aged, 80 & over Female Male ab: OBJECTIVE: Can indicative prevention of home-visiting nurses be effective when targeted at a frail senior population using multidimensional geriatric assessments and personalized care plans? METHODS: We performed an individually randomized controlled trial in 33 blinded primary care practices over 18 months. The 651 participants were aged 75 years or older, lived at home, and were frail but neither terminally ill nor demented. A score in the lowest quartile on at least two of six self-reported functional health domains (COOP-WONCA charts), defined frail health. We compared usual care with proactive home visits by trained community nurses. The nurses (a) assessed the care needs with a multidimensional computerized geriatric instrument, which enabled direct identification of health risks; (b) determined care priorities together with the person; (c) designed and executed individually tailored interventions; and (d) monitored participants by telephone and on average three home visits. Primary outcome measures were functional health and instrumental activities of daily living disability. Secondary outcomes were acute hospital admittance (time until), institutionalization, and mortality. RESULTS: We found no significant differences between intervention and usual care group on any of the outcome measures. Predefined subgroup analyses revealed a higher risk of hospital admission for persons with poor health in the intervention group. CONCLUSIONS: We could not demonstrate preventive effects of home visits by nurses in vulnerable older persons. Hospital admissions increased in the frailest group. The search for effective interventions for vulnerable persons requires further investigation. Future efforts may focus on improved integrated approaches. pubtype: Academic Journal doctype: research randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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