Nienke Bleijenberg|Irene Drubbel|Marieke J. Schuurmans|Hester ten Dam|Nicolaas P.A. Zuithoff|Mattijs E. Numans|Niek J. de Wit
Effectiveness of a Proactive Primary Care Program on Preserving Daily Functioning of Older People: A Cluster Randomized Controlled Trial
University Medical Center Utrecht|University Medical Center Utrecht|University Medical Center Utrecht|University Medical Center Utrecht|University Medical Center Utrecht|University Medical Center Utrecht
determine effectiveness proactive primary care program daily functioning older people primary caresingleblind threearm clusterrandomized controlled trial 1year followupprimary care setting 39 general practices netherlandscommunitydwelling people aged 60 older n 3092a frailty screening intervention using routine electronic medical record data identify older people risk adverse events followed usual care general practitioner screening intervention nurseled care program consisting comprehensive geriatric assessment evidencebased care planning care coordination followup usual careprimary outcome daily functioning measured using katz15 6 activities daily living adls 8 instrumental activities daily living iadls one mobility item range 015 higher scores indicate greater dependence secondary outcomes included quality life primary care consultations hospital admissions emergency department visits nursing home admissions mortalitythe participants intervention arms less decline daily functioning usual care arm 12 months mean katz15 score screening arm 187 95 confidence interval ci 177197 screening nurseled care arm 188 95 ci 180196 control group 203 95 ci 192213 p 03 differences quality life observedparticipants intervention groups less decline control group 1year followup despite statistically significant effect clinical relevance uncertain point small differences greater customizing intervention combined prolonged followup may lead morerobust results