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Fam Pract. 2009 Feb;26(1):56-64. doi: 10.1093/fampra/cmn094. Epub 2008 Dec 12.

A feasible model for prevention of functional decline in older home-dwelling people--the GP role. A municipality-randomized intervention trial.

Author information

1
Department of Public Health, University of Copenhagen, Denmark. m.vass@dadlnet.dk

Abstract

BACKGROUND:

Danish municipalities are required by state law to offer two annual home visits to all non-disabled citizens > or =75 years. Visits are primarily carried out by district nurses. GPs are rarely directly involved.

OBJECTIVE:

To evaluate the effects of offering an educational programme to home visitors and GPs on mortality, functional ability and nursing home admissions among home-dwelling older people.

METHODS:

DESIGN:

Municipality pair-matched randomized trial.

SETTING:

Danish primary care.

SUBJECT:

2863 home-dwelling 75-year-olds and 1171 home-dwelling 80-year-olds living in 34 municipalities.

INTERVENTION:

Home visitors received regular education for a period of 3 years. In nine of 17 intervention municipalities, GPs participated in one small group training session during the first year.

MAIN OUTCOME MEASURES:

Mortality, functional ability and nursing home admission during 4(1/2) years of follow-up.

RESULTS:

INTERVENTION was not associated with mortality. Home visitor education was associated with reduction in functional decline among home-dwelling 80-year-olds after the three intervention years in municipalities where GPs accepted and participated in small group-based training. Effects did not persist after the intervention ended. When analyses were restricted to baseline non-disabled persons, intervention was associated with beneficial effects on functional ability after three intervention years among 80-year-olds, regardless of education was given to home visitors alone or to visitors and GPs. Nursing home admission rates were lower among the 80-year-olds living in the intervention municipalities.

CONCLUSION:

A brief, practicable interdisciplinary educational programme for primary care professionals postponed functional decline in non-disabled 80-year-old home-dwelling persons.

PMID:
19074756
DOI:
10.1093/fampra/cmn094
[Indexed for MEDLINE]

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