Evidence map›Paper›PMID 24022033›Full record

Trial reportBMJ (Clinical research ed.)2013

Effectiveness of interdisciplinary primary care approach to reduce disability in community dwelling frail older people: cluster randomised controlled trial.

Silke F Metzelthin, Erik van Rossum, Luc P de Witte, Antonius W Ambergen, Sjoerd O Hobma, Walther Sipers, Gertrudis I J M Kempen

Open access · hybridAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 67 papers, 16 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
67citing papers in PubMed, 16 pooled it
9.1field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

67 citing papers in PubMed, 16 syntheses or guidelines pooled it, 166 citations in OpenAlex.

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  11. Delaying and reversing frailty: a systematic review of primary care interventions.The British journal of general practice : the journal of the Royal College of General Practitioners · 2019
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7 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Silke F MetzelthinDepartment of Health Services Research - Focusing on Chronic Care and Ageing, CAPHRI School for Public Health and Primary Care, Maastricht University, P O Box 616, 6200 MD Maastricht, Netherlands.
Erik van Rossum
Luc P de Witte
Antonius W Ambergen
Sjoerd O Hobma
Walther Sipers
Gertrudis I J M Kempen
Maastricht University · NLZuyd University of Applied Sciences · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate whether an interdisciplinary primary care approach for community dwelling frail older people is more effective than usual care in reducing disability and preventing (further) functional decline.

designCluster randomised controlled trial.

setting12 general practices in the south of the Netherlands

participants346 frail older people (score ≥ 5 on Groningen Frailty Indicator) were included; 270 (78%) completed the study.

interventionsGeneral practices were randomised to the intervention or control group. Practices in the control group delivered care as usual. Practices in the intervention group implemented the "Prevention of Care" (PoC) approach, in which frail older people received a multidimensional assessment and interdisciplinary care based on a tailor made treatment plan and regular evaluation and follow-up.

main outcome measuresThe primary outcome was disability, assessed at 24 months by means of the Groningen Activity Restriction Scale. Secondary outcomes were depressive symptomatology, social support interactions, fear of falling, and social participation. Outcomes were measured at baseline and at 6, 12, and 24 months' follow-up.

results193 older people in the intervention group (six practices) received the PoC approach; 153 older people in the control group (six practices) received care as usual. Follow-up rates for patients were 91% (n=316) at six months, 86% (n=298) at 12 months, and 78% (n=270) at 24 months. Mixed model multilevel analyses showed no significant differences between the two groups with regard to disability (primary outcome) and secondary outcomes. Pre-planned subgroup analyses confirmed these results.

conclusionsThis study found no evidence for the effectiveness of the PoC approach. The study contributes to the emerging body of evidence that community based care in frail older people is a challenging task. More research in this field is needed.

trial registrationCurrent Controlled Trials ISRCTN31954692.

Indexed as

Disability EvaluationFrail ElderlyAgedAged, 80 and overCluster AnalysisCommunity Health ServicesDelivery of Health Care, IntegratedFemaleGeriatric AssessmentHumansInterdisciplinary CommunicationMaleNetherlandsPrimary Health CarePrimary Prevention

Identifiers

PMID24022033
PMCPMC3769159
OpenAlexW2100248381

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.