Preventive Primary Care Outreach for High Risk Older Persons

NCT00134836 | Completed Phase 1

• 1 other identifier: PHCTF G03-02795
• Study Type: interventional
• Target: 719
• Locations: 1 country
• Sites: 1

Brief Summary

It is recognized that a significant proportion of seniors over 75 years of age are at risk of functional decline, and thus of institutionalization and death. The investigators at McMaster University Medical Centre, are conducting is a randomized controlled trial of a preventive primary care outreach (PPCO) service provided to high risk seniors living in the community. The goal of this service is to identify unrecognized problems and individuals at increased risk and to link individuals to care. This preventive primary care service is provided by nurse case managers. The investigators have recruited patients through their family physicians who work in primary care networks. The investigators are screening all seniors aged 75 and over within these practices. The sample includes seniors aged 75 and over who are identified to be at risk according to the Sherbrooke Postal Questionnaire. Patients are randomly allocated to intervention and control groups. A research assistant, who is blind to group allocation, will collect data from seniors at baseline, six months, and at the end of one year. Outcome measures include health-related quality of life (quality adjusted life years \[QALYs\]), health and social service utilization and costs, mortality, institutionalization, functional status, and perceived health status. Primary Hypothesis: The intervention compared to usual care will result in higher health-related quality of life. Secondary Hypotheses: Compared to usual care, the PPCO intervention will result in:

• the same or lower costs associated with service utilization;
• less functional decline;
• reduced mortality;
• lower rates of institutionalization; and
• better self-rated health.

Conditions

Frailty

Outcome Measures

Primary Outcomes (1)

• Health related quality of life (quality adjusted life years [QALYs])

  baseline, 6 months, 12 months

Secondary Outcomes (5)

• Health and social service utilization and costs

  baseline, 6 months, 12 months

• mortality

  12 months

• institutionalization

  12 months

• functional status

  baseline, 6 months, 12 months

• perceived health status

  baseline, 6 months, 12 months

Interventions

Preventive Primary Care Outreach BEHAVIORAL

Nurse home visit at baseline, 6 months, 12 months, including comprehensive assessment using MDS HC, care planning, referral to appropriate services

Also known as: nurse home visit

Eligibility Criteria

• Age: 75 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)

You may qualify if:

• Patient is 75 years of age and older
• Patient is listed on the roster of a participating family physician practice
• Patient resides in the Hamilton, Ontario, Canada area
• Patient or proxy able to answer questions in English

You may not qualify if:

• Principal residence is nursing home or long term care facility
• Patient is identified by family physician as palliative
• Patient currently receives home care services through the Community Care Access Centre
• Patient is a 'snowbird' and out of town for more than four weeks in any year
• Patient is scheduled for major elective surgery in the next year

Sponsors & Collaborators

• McMaster University: lead
• Ontario Ministry of Health and Long Term Care: collaborator

Study Sites (1)

McMaster University

Hamilton, Ontario, L8N 3Z5, Canada

Location

Related Publications (1)

• Ploeg J, Brazil K, Hutchison B, Kaczorowski J, Dalby DM, Goldsmith CH, Furlong W. Effect of preventive primary care outreach on health related quality of life among older adults at risk of functional decline: randomised controlled trial. BMJ. 2010 Apr 16;340:c1480. doi: 10.1136/bmj.c1480.

  PMID: 20400483 DERIVED

MeSH Terms

Conditions

Frailty

Condition Hierarchy (Ancestors)

Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Jenny Ploeg, RN, PhD

  School of Nursing, Faculty of Health Sciences, McMaster University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 1
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: PREVENTION
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER

Study Record Dates

• First Submitted: August 23, 2005
• First Posted: August 25, 2005
• Study Start: April 1, 2004
• Primary Completion: June 1, 2006
• Study Completion: June 1, 2006
• Last Updated: December 16, 2008

Record last verified: 2008-12

Locations

CA (1)