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

被引:0
|
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
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