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01.12.2012 | Study protocol | Ausgabe 1/2012 Open Access

BMC Health Services Research 1/2012

Comprehensive geriatric assessment, multifactorial interventions and nurse-led care coordination to prevent functional decline in community-dwelling older persons: protocol of a cluster randomized trial

Zeitschrift:
BMC Health Services Research > Ausgabe 1/2012
Autoren:
Jacqueline J Suijker, Bianca M Buurman, Gerben ter Riet, Marjon van Rijn, Rob J de Haan, Sophia E de Rooij, Eric P Moll van Charante
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1472-6963-12-85) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors' contributions

JS drafted the manuscript. JS and EMC wrote the protocol for the Medical Ethics Committee. BB, MvJ, RH, GtR, SR en EMC critically reviewed the manuscript and protocol for the Medical Ethics Committee. SR drafted the research proposal. BB, RH and EMC reviewed the research proposal that was sent to the funding organization. RH was involved in the methodological construct of the study. All authors read and approved the final version of the manuscript

Abstract

Background

Functional decline in community-dwelling older persons is associated with the loss of independence, the need for hospital and nursing-home care and premature death. The effectiveness of multifactorial interventions in preventing functional decline remains controversial. The aim of this study is to investigate whether functional decline in community-dwelling older persons can be delayed or prevented by a comprehensive geriatric assessment, multifactorial interventions and nurse-led care coordination.

Methods/Design

In a cluster randomized controlled trial, with the general practice as the unit of randomization, 1281 participants from 25 general practices will be enrolled in each condition to compare the intervention with usual care. The intervention will focus on older persons who are at increased risk for functional decline, identified by an Identification of Seniors at Risk Primary Care (ISAR-PC) score (≥ 2). These older persons will receive a comprehensive geriatric assessment, an individually tailored care and treatment plan, consisting of multifactorial, evidence-based interventions and subsequent nurse-led care coordination. The control group will receive 'care as usual' by the general practitioner (GP). The main outcome after 12 months is the level of physical functioning on the modified Katz-15 index score. The secondary outcomes are health-related quality of life, psychological and social functioning, healthcare utilization and institutionalization. Furthermore, a process evaluation and cost-effectiveness analysis will be performed.

Discussion

This study will provide new knowledge regarding the effectiveness and feasibility of a comprehensive geriatric assessment, multifactorial interventions and nurse-led elderly care in general practice.

Trial registration

Grant

Unrestricted grant 'The Netherlands Organisation for Health Research and development' no 313020201
Zusatzmaterial
Additional file 1: Web-appendix 1. The intervention study protocol. (DOC 74 KB)
12913_2012_1997_MOESM1_ESM.DOC
Authors’ original file for figure 1
12913_2012_1997_MOESM2_ESM.pdf
Literatur
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