Trial reportAnnals of family medicine
The cluster-randomized BRIGHT trial: Proactive case finding for community-dwelling older adults.
Trial report in Annals of family medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 3 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
14 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Community-based complex interventions to sustain independence in older people, stratified by frailty: a systematic review and network meta-analysis.Health technology assessment (Winchester, England) · 2024Pooled it
- Community based complex interventions to sustain independence in older people: systematic review and network meta-analysis.BMJ (Clinical research ed.) · 2024Pooled it
- The (cost-)effectiveness of preventive, integrated care for community-dwelling frail older people: A systematic review.Health & social care in the community · 2019Pooled it
- GP- and practice-related variation in ambulatory sensitive hospitalisations of older primary care patients.BMC family practice · 2020Trial
- Developing a Delphi Consensus on the Domains and Conduct of Brief Geriatric Assessments in Singapore.Annals of geriatric medicine and research · 2025Article
- Application and implementation of brief geriatric assessment in primary care and community settings: a scoping review.BMC geriatrics · 2025Article
- Article
- Does the shoe really fit? Characterising ill-fitting footwear among community-dwelling older adults attending geriatric services: an observational cross-sectional study.BMC geriatrics · 2020Article
- A Scoping Review of Nonpharmacological Interventions to Reduce Disability in Older Adults.The Gerontologist · 2020Article
- Quality of prescribing predicts hospitalisation in octogenarians: life and living in advanced age: a cohort study in New Zealand (LiLACS NZ).BMC geriatrics · 2019Article
- The effect of a gerontology nurse specialist for high needs older people in the community on healthcare utilisation: a controlled before-after study.BMC geriatrics · 2018Article
- Analysis of home-based rehabilitation in patients with motor impairment in primary care: a prospective observational study.BMC geriatrics · 2017Observational
- Primary Care Variation in Rates of Unplanned Hospitalizations, Functional Ability, and Quality of Life of Older People.Annals of family medicineArticle
- Interventions to Facilitate Access to Long-Term Care for Community-Dwelling Older Adults: A Scoping Review.Research on agingArticle
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposePeople are now living longer, but disability may affect the quality of those additional years of life. We undertook a trial to assess whether case finding reduces disability among older primary care patients.
methodsWe conducted a cluster-randomized trial of the Brief Risk Identification Geriatric Health Tool (BRIGHT) among 60 primary care practices in New Zealand, assigning them to an intervention or control group. Intervention practices sent a BRIGHT screening tool to older adults every birthday; those with a score of 3 or higher were referred to regional geriatric services for assessment and, if needed, service provision. Control practices provided usual care. Main outcomes, assessed in blinded fashion, were residential care placement and hospitalization, and secondary outcomes were disability, assessed with Nottingham Extended Activities of Daily Living Scale (NEADL), and quality of life, assessed with the World Health Organization Quality of Life scale, abbreviated version (WHOQOL-BREF).
resultsAll 8,308 community-dwelling patients aged 75 years and older were approached; 3,893 (47%) participated, of whom 3,010 (77%) completed the trial. Their mean age was 80.3 (SD 4.5) years, and 55% were women. Overall, 88% of the intervention group returned a BRIGHT tool; 549 patients were referred. After 36 months, patients in the intervention group were more likely than those in the control group to have been placed in residential care: 8.4% vs 6.2% (hazard ratio = 1.32; 95% CI, 1.04-1.68; P = .02). Intervention patients had smaller declines in mean scores for physical health-related quality of life (1.6 vs 2.9 points, P = .007) and psychological health-related quality of life (1.1 vs 2.4 points, P = .005). Hospitalization, disability, and use of services did not differ between groups, however.
conclusionsOur case-finding strategy was effective in increasing identification of older adults with disability, but there was little evidence of improved outcomes. Further research could trial stronger primary care integration strategies.
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