Citation

Metzelthin SF, van Rossum E, de Witte LP, Ambergen A, Hobma S, Sipers W, Daniels R, Habets H, Crasborn L, Kempen GIJM. Ned. Tijdschr. Geneeskd. 2014; 158: A7355.

Vernacular Title

Thuiswonende ouderen in een kwetsbare positie*

Affiliation

*Dit onderzoek werd eerder gepubliceerd in British Medical Journal (2013;347:f5264) met als titel 'Effectiveness of interdisciplinary primary care approach to reduce disability in community dwelling frail older people: cluster randomised controlled trial'. Afgedrukt met toestemming.

Copyright

(Copyright © 2014, Erven Bohn)

DOI

unavailable

PMID

24754931

Abstract

OBJECTIVE: To assess the added value of an interdisciplinary primary care programme for frail elderly people living at home with regard to reducing disability in activities of daily living and preventing functional decline or worsening thereof.

DESIGN: A cluster randomised trial.

METHOD: We sent a written survey, the Groningen Frailty Indicator (GFI), to 3498 patients ≥ 70 years from 12 general practitioner (GP) practices in the southern part of the Dutch province Limburg. GP practices in the control group (n = 6) delivered usual care, while the 6 intervention practices implemented the 'Prevention of Care' approach. Besides screening, this programme consists of a multidimensional assessment and interdisciplinary care based on a tailor-made treatment plan and regular evaluation and follow-up. The GP and practice nurse make up the core team in this approach and closely collaborate with occupational therapists and physiotherapists. The primary outcome measure was disability in activities of daily living. This primary outcome and various secondary outcomes such as social support, fear of falling and quality of life were assessed at baseline and after 6, 12 and 24 months of follow-up (trial registered with Current Controlled Trials, ISRCTN31954692).

RESULTS: The response rate to the postal screening was 80%. Out of 1101 elderly people who were willing to participate in the study, 393 (36%) were frail according to the GFI (score ≥ 5). Finally, 346 frail elderly people were included of whom 270 completed the study. Multi-level analyses showed no significant differences between the two groups in any of the primary and secondary outcomes.

CONCLUSION: No evidence for the effectiveness of the Prevention of Care approach was found. This study contributes to the emerging body of evidence that primary care of frail elderly people is a challenging task.

Language: nl