Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2012 Dec;60(12):2223-31.
doi: 10.1111/jgs.12026. Epub 2012 Nov 29.

Effects of an advanced practice nurse in-home health consultation program for community-dwelling persons aged 80 and older

Lorenz Imhof  1 , Rahel Naef, Margaret I Wallhagen, Jürg Schwarz, Romy Mahrer-Imhof
Affiliations
Free PMC article
Randomized Controlled Trial

Effects of an advanced practice nurse in-home health consultation program for community-dwelling persons aged 80 and older

Lorenz Imhof et al. J Am Geriatr Soc. 2012 Dec.
Free PMC article

Abstract

Objectives: To evaluate the effects of an advanced practice nurse (APN) in-home health consultation program (HCP) on quality of life, health indicators (falls, acute events), and healthcare utilization.

Design: Randomized clinical trial.

Setting: One urban area in the German-speaking part of Switzerland.

Participants: Four hundred sixty-one community-dwelling individuals aged 80 and older (mean age 85, 72.7% female, all Caucasian) participated in the intervention (n = 231) and control (n = 230) groups.

Intervention: After a comprehensive geriatric assessment, participants were randomly assigned to the 9-month HCP with four in-home visits and three phone calls from APNs or to a control group with standard care with no intervention.

Measurements: The primary outcome was quality of life at 3, 6, and 9 months. Secondary outcomes were incidence of falls, acute events due to health problems, and healthcare utilization measured for 3-month periods at 3, 6, and 9 months.

Results: The intervention and control groups did not differ significantly on any dimension of the World Health Organization Quality of Life questionnaire but differed significantly over 9 months in self-reported acute events (116 vs 168, relative risk (RR) = 0.70, P = .001), falls (74 vs 101, RR = 0.71, P = .003), consequences of falls (63.1% vs 78.7%, chi-square = 7.39, P = .007), and hospitalizations (47 vs 68, RR = .70, P = .03).

Conclusion: The in-home HCP provided by APNs and guided by the principles of health promotion, empowerment, partnership, and family-centeredness, can be effective in reducing adverse health outcomes such as falls, acute events, and hospitalizations.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Participant flow.
Figure 2
Figure 2
Intervention.
See this image and copyright information in PMC

References

    1. Bodenheimer T, Lorig K, Holman H, et al. Patient self-management of chronic disease in primary care. JAMA. 2002;288:2469–2475. - PubMed
    1. Bodenheimer T, Wagner EH, Grumbach K. Improving primary care for patients with chronic illness. JAMA. 2002;288:1909–1914. - PubMed
    1. Glynn LG, Murphy AW, Smith SM, et al. Interventions used to improve control of blood pressure in patients with hypertension. Cochrane Database Syst Rev. 2010 Available at http://www.mrw.interscience.wiley.com/cochrane. Accessed January 15, 2012. - PubMed
    1. Renders CM, Valk GD, Griffin SJ, et al. Interventions to improve the management of diabetes mellitus in primary care, outpatient and community settings. Cochrane Database Syst Rev. 2000 Available at http://www.mrw.interscience.wiley.com/cochrane/. Accessed January 15, 2012. - PMC - PubMed
    1. Sit JWH, Yip VYB, Ko SKK, et al. A quasi-experimental study on a community-based stroke prevention programme for clients with minor stroke. J Clin Nurs. 2007;16:272–281. - PubMed

Publication types