Integrated Systematic Care for Older PEople.

Pro-active care for older people at risk for functional decline: Screening for vulnerability and effectiveness of a subsequent guided care plan in primary care.

Status

Active, not recruiting

Phases

Unknown

Study type

Interventional

Source

NL-OMON

Registry ID

NL-OMON24755

Enrollment

10000

Registered

2009-08-10

Start date

2009-09-01

Completion date

Unknown

Last updated

2024-02-28

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

ENGLISH: frailty, older people with multiple problems DUTCH: kwetsbare ouderen, ouderen met meerdere problemen

Interventions

The GP's formulate a care action plan for frail elderly.

Eligibility

Inclusion criteria

Inclusion criteria: Inclusion criteria for screening: 1. People aged 75 years and over; 2. Enlisted in general practices. Inclusion criteria for GP care plan in intervention practices: 1. Poor performance on >3 out of 4 domains on screening questionnaire.

Exclusion criteria

Exclusion criteria: Exclusion criteria for screening: 1. Terminal illness (life expectancy < 3 months). Exclusion criteria for GP care plan: None.

Design outcomes

Primary

Measure	Time frame
Difference in quality of life, functional status of the participants in the intervention group versus the control group after 12 months.	—

Secondary

Measure	Time frame
1. Satisfaction of older persons, caretakers and caregivers with delivered care; 2. Indicators for proactive, coherent care; 3. Costs per quality adjusted life years (QALY).	—

Contacts

Public ContactJ.W. Blom

Leiden University Medical Center (LUMC), Department of Public Health and Primary Care, Postzone V-0-P, P.O. Box 9600

J.W.Blom@lumc.nl+31 (0)71 5268406

Outcome results

None listed

Source: NL-OMON (via WHO ICTRP)