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
Clinical Trial
. 2016 Feb 15:16:43.
doi: 10.1186/s12877-016-0214-5.

The effects of a pro-active integrated care intervention for frail community-dwelling older people: a quasi-experimental study with the GP-practice as single entry point

Wilhelmina Mijntje Looman  1 , Isabelle Natalina Fabbricotti  2 , Ruben de Kuyper  2 , Robbert Huijsman  2
Affiliations
Clinical Trial

The effects of a pro-active integrated care intervention for frail community-dwelling older people: a quasi-experimental study with the GP-practice as single entry point

Wilhelmina Mijntje Looman et al. BMC Geriatr. .

Abstract

Background: This study explored the effectiveness of a pro-active, integrated care model for community-dwelling frail older people compared to care as usual by evaluating the effects on a comprehensive set of outcomes: health outcomes (experienced health, mental health and social functioning); functional abilities; and quality of life (general, health-related and well-being).

Methods: The design of this study was quasi-experimental. In this study, 184 frail older patients of three GP practices that implemented the Walcheren Integrated Care Model were compared with 193 frail older patients of five GP practices that provided care as usual. In the Walcheren Integrated Care Model, community-dwelling elderly were pro-actively screened for frailty from the GP practice using the Groningen Frailty Indicator, and care needs were assessed with the EASYcare instrument. The GP practice functioned as single entry point from which case management was provided, and the GP was the coordinator of care. The entire process was supported by multidisciplinary meetings, multidisciplinary protocols and web-based patient files. The outcomes of this study were obtained at baseline, after 3 months and after 12 months and analyzed with linear mixed models of repeated measures.

Results: The Walcheren Integrated Care Model had a positive effect on love and friendship and a moderately positive effect on general quality of life. The ability to receive love and friendship and general quality of life decreased in the control group but was preserved in the experimental group. No significant differences were found on health outcomes such as experienced health, mental health, social functioning and functional abilities.

Conclusions: The results indicated that pro-active, integrated care can be beneficial for frail older people in terms of quality of life and love and friendship but not in terms of health outcomes and functional abilities. Recommendations for future research are to gain greater insight into what specific outcomes can be achieved with proactive and integrated care, considering the specific content of this care, and to allow for the heterogeneity of frail older people in evaluation research.

Trial registration: Current Controlled Trials ISRCTN05748494. Registration date: 14/03/2013.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Flow chart of participants
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. WHO . Global health and Ageing. National Institute on Aging. 2011.
    1. Friedman SM, Steinwachs DM, Rathouz PJ, Burton LC, Mukamel DB. Characteristics Predicting Nursing Home Admission in the Program of All-Inclusive Care for Elderly People. Gerontologist. 2005;45:157–66. doi: 10.1093/geront/45.2.157. - DOI - PubMed
    1. Wiles JL, Leibing A, Guberman N, Reeve J, Allen RES. The Meaning of “Ageing in Place” to Older People. Gerontologist. 2011;52:357–66. doi: 10.1093/geront/gnr098. - DOI - PubMed
    1. Gobbens RJJ, Luijkx KG, Wijnen-Sponselee MTH, Schols JMGA. Towards a conceptual definition of frail community-dwelling older people. Nurs Outlook. 2010;58(2):76–86. doi: 10.1016/j.outlook.2009.09.005. - DOI - PubMed
    1. Schers HJ, Koopmans R, Olde RM. De rol van de huisarts bij kwetsbare ouderen. Een internetenquête onder huisartsen [The role of the GP for frail elderly. An internet survey among GPs] Huisarts Wet. 2009;52(13):626–30. doi: 10.1007/BF03085828. - DOI

Publication types

Associated data

LinkOut - more resources