A randomised controlled trial of the outcome of health assessment of people aged 75 years and over

Abstract

Objectives: To measure the outcomes of a health assessment, conducted by a nurse, of people aged 75 years and older (75+HA) living independently in their own homes.

Design: Randomised controlled trial (RCT).

Setting: A convenience sample of six general practices within the Adelaide Western Division of General Practice (AWDGP). A random sample of 100 participants was drawn from practice age-sex registers. Data were collected in initial visits between 1 August 1998 and February 1999, then in follow-up visits one year later.

Participants: Participants were aged 75 years and over on 1 August 1998 and living independently in the community. 145 eligible patients were invited to join the study, and 100 of these consented to enrol (69%).

Intervention: A 75+HA conducted in the participant's home by a nurse and reported to their usual general practitioner.

Main outcome measures: Primary: number of problems in each group; number of participants with problems; and mortality. Secondary: physical function; psychological (including cognitive) function; falls; and admission to institution.

Results: There were no significant differences between the control and intervention groups at follow-up in the number of problems, the number of participants with problems, or mortality. In the intervention group, there was significant improvement in self-rated health, geriatric depression score (GDS 15), and number of falls.

Conclusions: This RCT has not demonstrated improvement in health status of the intervention group which received a 75+HA compared with a control group left to usual care.