• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of cmajCMAJ Information for AuthorsCMAJ Home Page
CMAJ. Feb 22, 2000; 162(4): 497–500.
PMCID: PMC1231166

Effect of preventive home visits by a nurse on the outcomes of frail elderly people in the community: a randomized controlled trial

Abstract

BACKGROUND: Timely recognition and prevention of health problems among elderly people have been shown to improve their health. In this randomized controlled trial the authors examined the impact of preventive home visits by a nurse compared with usual care on the outcomes of frail elderly people living in the community. METHODS: A screening questionnaire identified eligible participants (those aged 70 years or more at risk of sudden deterioration in health). Those randomly assigned to the visiting nurse group were assessed and followed up in their homes for 14 months. The primary outcome measure was the combined rate of deaths and admissions to an institution, and the secondary outcome measure the rate of health services utilization, during the 14 months; these rates were determined through a medical chart audit by a research nurse who was blind to group allocation. RESULTS: The questionnaire was mailed to 415 elderly people, of whom 369 (88.9%) responded. Of these, 198 (53.7%) were eligible, and 142 consented to participate and were randomly assigned to either the visiting nurse group (73) or the usual care group (69). The combined rate of deaths and admissions to an institution was 10.0% in the visiting nurse group and 5.8% in the usual care group (p = 0.52). The rate of health services utilization did not differ significantly between the 2 groups. Influenza and pneumonia vaccination rates were significantly higher in the visiting nurse group (90.1% and 81.9%) than in the usual care group (53.0% and 0%) (p < 0.001). INTERPRETATION: The trial failed to show any effect of a visiting nurse other than vastly improved vaccination coverage.

Full Text

The Full Text of this article is available as a PDF (232K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Hay WI, Browne G, Roberts J, Jamieson E. Prospective care of elderly patients in family practice. Part 3: Prevalence of unrecognized treatable health concerns. Can Fam Physician. 1995 Oct;41:1695–1710. [PMC free article] [PubMed]
  • Pathy MS, Bayer A, Harding K, Dibble A. Randomised trial of case finding and surveillance of elderly people at home. Lancet. 1992 Oct 10;340(8824):890–893. [PubMed]
  • Cadman D, Chambers L, Feldman W, Sackett D. Assessing the effectiveness of community screening programs. JAMA. 1984 Mar 23;251(12):1580–1585. [PubMed]
  • Stuck AE, Siu AL, Wieland GD, Adams J, Rubenstein LZ. Comprehensive geriatric assessment: a meta-analysis of controlled trials. Lancet. 1993 Oct 23;342(8878):1032–1036. [PubMed]
  • van Rossum E, Frederiks CM, Philipsen H, Portengen K, Wiskerke J, Knipschild P. Effects of preventive home visits to elderly people. BMJ. 1993 Jul 3;307(6895):27–32. [PMC free article] [PubMed]
  • Hay WI, van Ineveld C, Browne G, Roberts J, Bell B, Mills M, Chambers L, Gafni A, Macpherson S. Prospective care of elderly patients in family practice. Is screening effective? Can Fam Physician. 1998 Dec;44:2677–2687. [PMC free article] [PubMed]
  • Dalby DM, Sellors JW, Fraser FD, Fraser C, van Ineveld CH, Pickard L, Howard M. Screening seniors for risk of functional decline: results of a survey in family practice. Can J Public Health. 1999 Mar-Apr;90(2):133–137. [PubMed]
  • Stuck AE, Aronow HU, Steiner A, Alessi CA, Büla CJ, Gold MN, Yuhas KE, Nisenbaum R, Rubenstein LZ, Beck JC. A trial of annual in-home comprehensive geriatric assessments for elderly people living in the community. N Engl J Med. 1995 Nov 2;333(18):1184–1189. [PubMed]
  • Tulloch AJ, Moore V. A randomized controlled trial of geriatric screening and surveillance in general practice. J R Coll Gen Pract. 1979 Dec;29(209):733–740. [PMC free article] [PubMed]
  • Vetter NJ, Jones DA, Victor CR. Effect of health visitors working with elderly patients in general practice: a randomised controlled trial. Br Med J (Clin Res Ed) 1984 Feb 4;288(6414):369–372. [PMC free article] [PubMed]
  • Carpenter GI, Demopoulos GR. Screening the elderly in the community: controlled trial of dependency surveillance using a questionnaire administered by volunteers. BMJ. 1990 May 12;300(6734):1253–1256. [PMC free article] [PubMed]

Articles from CMAJ : Canadian Medical Association Journal are provided here courtesy of Canadian Medical Association

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

  • Cited in Books
    Cited in Books
    PubMed Central articles cited in books
  • MedGen
    MedGen
    Related information in MedGen
  • PubMed
    PubMed
    PubMed citations for these articles
  • Substance
    Substance
    PubChem Substance links

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...