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
. 2013 Jul-Aug;62(4):269-78.
doi: 10.1097/NNR.0b013e318298aa55.

Nurse care coordination and technology effects on health status of frail older adults via enhanced self-management of medication: randomized clinical trial to test efficacy

Karen Dorman Marek  1 , Frank Stetzer, Polly A Ryan, Linda Denison Bub, Scott J Adams, Andrea Schlidt, Rachelle Lancaster, Anne-Marie O'Brien
Affiliations
Randomized Controlled Trial

Nurse care coordination and technology effects on health status of frail older adults via enhanced self-management of medication: randomized clinical trial to test efficacy

Karen Dorman Marek et al. Nurs Res. 2013 Jul-Aug.

Abstract

Background: Self-management of complex medication regimens for chronic illness is challenging for many older adults.

Objectives: The purpose of this study was to evaluate health status outcomes of frail older adults receiving a home-based support program that emphasized self-management of medications using both care coordination and technology.

Design: This study used a randomized controlled trial with three arms and longitudinal outcome measurement.

Setting: Older adults having difficulty in self-managing medications (n = 414) were recruited at discharge from three Medicare-certified home healthcare agencies in a Midwestern urban area.

Methods: All participants received baseline pharmacy screens. The control group received no further intervention. A team of advanced practice nurses and registered nurses coordinated care for 12 months to two intervention groups who also received either an MD.2 medication-dispensing machine or a medplanner. Health status outcomes (the Geriatric Depression Scale, Mini Mental Status Examination, Physical Performance Test, and SF-36 Physical Component Summary and Mental Component Summary) were measured at baseline and at 3, 6, 9, and 12 months.

Results: After covariate and baseline health status adjustment, time × group interactions for the MD.2 and medplanner groups on health status outcomes were not significant. Time × group interactions were significant for the medplanner and control group comparisons.

Discussion: Participants with care coordination had significantly better health status outcomes over time than those in the control group, but addition of the MD.2 machine to nurse care coordination did not result in better health status outcomes.

Trial registration: ClinicalTrials.gov NCT01321853.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flow of participants through the study.
Figure 2
Figure 2
Covariate adjusted mean outcome scores with 95% CI by group over 12-month period.
Figure 2
Figure 2
Covariate adjusted mean outcome scores with 95% CI by group over 12-month period.
Figure 2
Figure 2
Covariate adjusted mean outcome scores with 95% CI by group over 12-month period.
See this image and copyright information in PMC

References

    1. Brown R, Peikes D, Chen A, Ng J, Schore J, Soh C. The evaluation of the Medicare Coordinated Care Demonstration: Findings for the first two years. Mathematica Policy Research; Princeton, NJ: 2007. (MPR Reference No.: 8756-420)
    1. Brown R, Peikes D, Chen A, Schore J. 15-site randomized trial of coordinated care in Medicare FFS. Health Care Financing Review. 2008;30:5–25. - PMC - PubMed
    1. Brown RS, Peikes D, Peterson G, Schore J, Razafindrakoto CM. Six features of Medicare coordinated care demonstration programs that cut hospital admissions of high-risk patients. Health Affairs. 2012;31:1156–1166. - PubMed
    1. Buckwalter KC, Wakefield BJ, Hanna B, Lehmann J. New technology for medication adherence: Electronically managed medication dispensing system. Journal of Gerontological Nursing. 2004;30(7):5–8. - PubMed
    1. CareFacts™ [Retrieved April 23, 2013];CareFacts Information Systems. 2012 from http://www.carefacts.com.

Publication types

Associated data