A nurse-led comprehensive geriatric assessment intervention in primary care: A feasibility cluster randomized controlled trial

被引:3
作者
Lyndon, Helen [1 ]
Latour, Jos M. M. [2 ,3 ]
Marsden, Jonathan [2 ]
Kent, Bridie [2 ]
机构
[1] Cornwall Fdn NHS Trust, Cornwall, England
[2] Univ Plymouth, Plymouth, England
[3] Curtin Univ, Perth, Australia
基金
美国国家卫生研究院;
关键词
cluster trial; comprehensive geriatric assessment; feasibility; frailty; nurse-led; older people; primary care; DWELLING OLDER-PEOPLE; PRIMARY-HEALTH-CARE; IMPROVING RECRUITMENT; CLINICAL-TRIALS; FRAILTY; PREVALENCE; DISABILITY; PROGRAMS; OUTCOMES; PATIENT;
D O I
10.1111/jan.15652
中图分类号
R47 [护理学];
学科分类号
1011 ;
摘要
Aim: To determine the feasibility of a nurse- led, primary care- based comprehensive geriatric assessment (CGA) intervention.Design: A feasibility cluster randomized controlled trial.Methods: The trial was conducted in six general practices in the United Kingdom from May 2018 to April 2020. Participants were moderately/severely frail people aged 65 years and older living at home. Clusters were randomly assigned to the inter-vention arm control arms. A CGA was delivered to the intervention participants, with control participants receiving usual care. Study outcomes related to feasibility of the intervention and of conducting the trial including recruitment and retention. A range of outcome measures of quality of life, function, loneliness, self-determination, mortality, hospital admission/readmission and number of prescribed medications were evaluated.Results: All pre-specified feasibility criteria relating to recruitment and retention were met with 56 participants recruited in total (30 intervention and 26 control). Retention was high with 94.6% of participants completing 13- week follow- up and 87.5% (n = 49) completing 26- week follow- up. All outcome measures instruments met feasibility cri-teria relating to completeness and responsiveness over time. Quality of life was recommended as the primary outcome for a definitive trial with numbers of prescribed medications as a secondary outcome measure.Conclusion: It is feasible to implement and conduct a randomized controlled trial of a nurse- led, primary care- based CGA intervention. Impact: The study provided evidence on the feasibility of a CGA intervention for older people delivered in primary care. It provides information to maximize the success of a definitive trial of the clinical effectiveness of the intervention.Patient or Public Contribution: Patient and public representatives were involved in the study design including intervention development and production of participant-facing documentation. Representatives served on the trial management and steering committees and, as part of this role, interpreted feasibility data. ISRCTN Number: 74345449.
引用
收藏
页码:3473 / 3486
页数:14
相关论文
共 59 条
[1]  
Age UK, 2014, FIT FRAILTY CONSENSU
[2]   Standard set of health outcome measures for older persons [J].
Akpan, Asangaedem ;
Roberts, Charlotte ;
Bandeen-Roche, Karen ;
Batty, Barbara ;
Bausewein, Claudia ;
Bell, Diane ;
Bramley, David ;
Bynum, Julie ;
Cameron, Ian D. ;
Chen, Liang-Kung ;
Ekdahl, Anne ;
Fertig, Arnold ;
Gentry, Tom ;
Harkes, Marleen ;
Haslehurst, Donna ;
Hope, Jonathon ;
Hurtado, Diana Rodriguez ;
Lyndon, Helen ;
Lynn, Joanne ;
Martin, Mike ;
Isden, Ruthe ;
Raso, Francesco Mattace ;
Shaibu, Sheila ;
Shand, Jenny ;
Sherrington, Cathie ;
Sinha, Samir ;
Turner, Gill ;
De Vries, Nienke ;
Yi, George Jia-Chyi ;
Young, John ;
Banerjee, Jay .
BMC GERIATRICS, 2018, 18
[3]  
Alharbi Khulud, 2020, BJGP Open, V4, DOI [10.3399/bjgpopen20x101019, 10.3399/bjgpopen20X101019]
[4]   Lessons learned from a multidisciplinary heart failure clinic for older women: a randomised controlled trial [J].
Azad, Nahid ;
Molnar, Frank ;
Byszewski, Anna .
AGE AND AGEING, 2008, 37 (03) :282-287
[5]   Patient Characteristics Associated With a Successful Response to Nurse-Led Care Programs Targeting the Oldest-Old: A Comparison of Two RCTs [J].
Bleijenberg, Nienke ;
Imhof, Lorenz ;
Mahrer-Imhof, Romy ;
Wallhagen, Margaret I. ;
de Wit, Niek J. ;
Schuurmans, Marieke J. .
WORLDVIEWS ON EVIDENCE-BASED NURSING, 2017, 14 (03) :210-222
[6]   Using the SF-36 and Euroqol on an elderly population [J].
Brazier, JE ;
Walters, SJ ;
Nicholl, JP ;
Kohler, B .
QUALITY OF LIFE RESEARCH, 1996, 5 (02) :195-204
[7]  
Britain Thinks, 2015, FRAILT LANG PERC REP
[8]   Strategies to improve retention in randomised trials: a Cochrane systematic review and meta-analysis [J].
Brueton, V. C. ;
Tierney, J. F. ;
Stenning, S. ;
Meredith, S. ;
Harding, S. ;
Nazareth, I. ;
Rait, G. .
BMJ OPEN, 2014, 4 (02)
[9]   Community matrons: primary care professionals' views and experiences [J].
Chapman, Linda ;
Smith, Anne ;
Williams, Veronika ;
Oliver, David .
JOURNAL OF ADVANCED NURSING, 2009, 65 (08) :1617-1625
[10]   Differences between patient and proxy reports in the assessment of disability after stroke [J].
Chen, Mei-Hsiang ;
Hsieh, Ching-Lin ;
Mao, Hui-Fen ;
Huang, Sheau-Ling .
CLINICAL REHABILITATION, 2007, 21 (04) :351-356