Geriatrician-performed comprehensive geriatric care in older adults referred to an outpatient community rehabilitation unit: A randomized controlled trial

Abstract

Background: Older adults make increasing demands on all sectors of the healthcare system. We investigated the effect of geriatrician-performed comprehensive geriatric care (CGC) in older adults referred to an outpatient community rehabilitation unit.

Design: Randomized controlled trial.

Setting: Two Danish non-hospital based rehabilitation units.

Participants: Persons aged 65 or older admitted from home or hospital.

Intervention: CGC performed by a geriatrician at the rehabilitation unit.

Outcomes: Primary outcome was number of hospital admissions and emergency department (ED) visits. Secondary outcomes were number of ambulatory contacts, general practitioner (GP) contacts, activities of daily living (ADL) and overall quality of life (OQoL). Outcomes were measured within 90 days of admission to the rehabilitation units.

Results: 368 persons were randomized: 185 to the intervention group (IG) vs 183 to the control group (CG). Groups were comparable at baseline. The number of hospital admissions and ED visits, ambulatory contacts and out of hour GP visits or phone calls did not differ between the groups. The number of daytime GP consultations and visits or phone and email consultations was lower in the IG (P < 0.001). There were no differences in the mean between the groups for ADL and OQoL, but more participants in the IG improved their OQoL (OR 1.63, 95% CI: 1.07-2.48, P = 0.023).

Conclusion: Geriatrician-performed CGC in older adults in an outpatient community rehabilitation unit had no effect on the secondary healthcare utilization, but may reduce primary healthcare utilization and improve OQoL during the 90-day follow-up period.

Trial registration: ClinicalTrials.govNCT01506219.

Keywords: Activities of daily living; Comprehensive geriatric care; Healthcare utilization; Outpatient community rehabilitation unit; Quality of life; Randomized controlled trial.