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Randomized Controlled Trial
. 2023 Mar 1;52(3):afad022.
doi: 10.1093/ageing/afad022.

Cluster randomised trial of a complex interprofessional intervention (interprof ACT) to reduce hospital admission of nursing home residents

Ana Mazur  1 , Britta Tetzlaff  2 , Tina Mallon  2 , Berit Hesjedal-Streller  1 , Vivien Wei  1 , Martin Scherer  2 , Sascha Köpke  3 , Katrin Balzer  4 , Linda Steyer  4 , Tim Friede  5 , Sebastian Pfeiffer  5 , Eva Hummers  1 , Christiane Müller  1
Affiliations
Randomized Controlled Trial

Cluster randomised trial of a complex interprofessional intervention (interprof ACT) to reduce hospital admission of nursing home residents

Ana Mazur et al. Age Ageing. .

Abstract

Background: Some hospital admissions of nursing home residents (NHRs) might be attributed to inadequate interprofessional collaboration. To improve general practitioner-nurse collaboration in nursing homes (NHs), we developed an intervention package (interprof ACT) in a previous study.

Objective: To assess the impact of interprof ACT on the proportion of hospitalisation and other clinical parameters within 12 months from randomisation among NHRs.

Methods: Multicentre, cluster randomised controlled trial in 34 German NHs. NHRs of the control group received usual care, whereas NHRs in the intervention group received interprof ACT. Eligible NHs had at least 40 long-term care residents. NHs were randomised 1:1 pairwise. Blinded assessors collected primary outcome data.

Results: Seventeen NHs (320 NHRs) were assigned to interprof ACT and 17 NHs (323 NHRs) to usual care. In the intervention group, 136 (42.5%) NHRs were hospitalised at least once within 12 months from randomisation and 151 (46.7%) in the control group (odds ratio (OR): 0.82, 95% confidence interval (CI): [0.55; 1.22], P = 0.33). No differences were found for the average number of hospitalisations: 0.8 hospitalisations per NHR (rate ratio (RR) 0.90, 95% CI: [0.66, 1.25], P = 0.54). Average length of stay was 5.7 days for NHRs in the intervention group and 6.5 days in the control group (RR: 0.70, 95% CI: [0.45, 1.11], P = 0.13). Falls were the most common adverse event, but none was related to the study intervention.

Conclusions: The implementation of interprof ACT did not show a statistically significant and clinically relevant effect on hospital admission of NHRs.

Trial registration: ClinicalTrials.gov NCT03426475.

Keywords: cluster randomised controlled trial; interprofessional relations; nursing homes; older people; patient-centred care; physician–nurse relations.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Interprof ACT components and strategies of implementation. NHR: nursing home resident, GP: general practitioner.
Figure 2
Figure 2
CONSORT flow diagram.
See this image and copyright information in PMC

References

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