An In-Home Preventive Assessment Program for Independent Older Adults: A Randomized Controlled Trial

摘要: Objective: To evaluate the effectiveness of in-home geriatric assessments as a means providing preventive health care and improving functional status community-living elderly veterans. Design: Randomized controlled trial with 1-year follow-up. Setting: Home visits performed in suburb Los Angeles. Participants: Community-living veterans 70 years older not currently receiving at Sepulveda VA Medical Center (n = 131 intervention; 123 controls). Intervention: A home visit by physician's assistant or nurse, to screen for medical, psychosocial problems, followed letter describing findings recommendations, follow-up trained volunteers 4-month intervals 1 year. Controls received only telephone interviews collect outcome data. Measurements: Compliance recommendations was studied intervention group. Outcome comparisons between two groups included: mortality, medication usage, status, immunization rates, nursing hospital utilization. Main Results: mean four new suboptimally treated problems identified subjects. Subjects complied 76% see physician initiate specific practice. At 12-month follow-up, subjects had significantly increased their rates (P < 0.001) likelihood having primary 0.05). Twelve-month (IADL) scores were higher than controls; maintained while controls experienced significant decline during year Non-prescription drug use among controls, but 0.05). Conclusions: brief screening assessment can detect unrecognized treatable even relatively healthy adults. The is feasible strategy education contacts. These results support concept that gerontological approaches help maintain important aspects function.