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
. 2018 Jan 19;13(1):e0190751.
doi: 10.1371/journal.pone.0190751. eCollection 2018.

Effects of a population-based, person-centred and integrated care service on health, wellbeing and self-management of community-living older adults: A randomised controlled trial on Embrace

Sophie L W Spoorenberg  1 , Klaske Wynia  1   2 , Ronald J Uittenbroek  1 , Hubertus P H Kremer  2 , Sijmen A Reijneveld  1
Affiliations
Randomized Controlled Trial

Effects of a population-based, person-centred and integrated care service on health, wellbeing and self-management of community-living older adults: A randomised controlled trial on Embrace

Sophie L W Spoorenberg et al. PLoS One. .

Abstract

Objective: To evaluate the effects of the population-based, person-centred and integrated care service 'Embrace' at twelve months on three domains comprising health, wellbeing and self-management among community-living older people.

Methods: Embrace supports older adults to age in place. A multidisciplinary team provides care and support, with intensity depending on the older adults' risk profile. A randomised controlled trial was conducted in fifteen general practices in the Netherlands. Older adults (≥75 years) were included and stratified into three risk profiles: Robust, Frail and Complex care needs, and randomised to Embrace or care as usual (CAU). Outcomes were recorded in three domains. The EuroQol-5D-3L and visual analogue scale, INTERMED for the Elderly Self-Assessment, Groningen Frailty Indicator and Katz-15 were used for the domain 'Health.' The Groningen Well-being Indicator and two quality of life questions measured 'Wellbeing.' The Self-Management Ability Scale and Partners in Health scale for older adults (PIH-OA) were used for 'Self-management.' Primary and secondary outcome measurements differed per risk profile. Data were analysed with multilevel mixed-model techniques using intention-to-treat and complete case analyses, for the whole sample and per risk profile.

Results: 1456 eligible older adults participated (49%) and were randomized to Embrace (n(T0) = 747, n(T1) = 570, mean age 80.6 years (SD 4.5), 54.2% female) and CAU (n(T0) = 709, n(T1) = 561, mean age 80.8 years (SD 4.7), 55.6% female). Embrace participants showed a greater-but clinically irrelevant-improvement in self-management (PIH-OA Knowledge subscale effect size [ES] = 0.14), and a greater-but clinically relevant-deterioration in health (ADL ES = 0.10; physical ADL ES = 0.13) compared to CAU. No differences in change in wellbeing were observed. This picture was also found in the risk profiles. Complete case analyses showed comparable results.

Conclusions: This study found no clear benefits to receiving person-centred and integrated care for twelve months for the domains of health, wellbeing and self-management in community-living older adults.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. CONSORT flow diagram of the Embrace study.
See this image and copyright information in PMC

References

    1. Sixsmith J, Sixsmith A, Fange AM, Naumann D, Kucsera C, Tomsone S, et al. Healthy ageing and home: the perspectives of very old people in five European countries. Soc Sci Med. 2014;106: 1–9. doi: 10.1016/j.socscimed.2014.01.006 - DOI - PubMed
    1. Lofqvist C, Granbom M, Himmelsbach I, Iwarsson S, Oswald F, Haak M. Voices on relocation and aging in place in very old age—a complex and ambivalent matter. Gerontologist. 2013;53: 919–927. doi: 10.1093/geront/gnt034 - DOI - PubMed
    1. Wiles JL, Leibing A, Guberman N, Reeve J, Allen RE. The meaning of "aging in place" to older people. Gerontologist. 2012;52: 357–366. doi: 10.1093/geront/gnr098 - DOI - PubMed
    1. Spoorenberg SL, Reijneveld SA, Middel B, Uittenbroek RJ, Kremer HP, Wynia K. The Geriatric ICF Core Set reflecting health-related problems in community-living older adults aged 75 years and older without dementia: development and validation. Disabil Rehabil. 2015;37: 2337–2343. doi: 10.3109/09638288.2015.1024337 - DOI - PubMed
    1. Chen Y, Feeley TH. Social support, social strain, loneliness, and well-being among older adults: an analysis of the Health and Retirement Study. JSPR. 2014;31: 141.

Publication types

LinkOut - more resources