title: Effectiveness of a geriatric intervention in primary care: a randomized clinical trial.
abstract: OBJECTIVE
  To assess the effectiveness of an intervention after comprehensive geriatric assessment (CGA) in reducing morbidity and mortality in patients over 74 years in primary care.
  
  
  METHODS
  Randomized controlled trial with 18 months of follow-up. Patients in the control group (CG) followed usual care. Patients in the intervention group (IG) were classified as at risk or non-risk of frailty based on the CGA. Patients at non-risk of frailty in the IG were provided with recommendations about healthy habits and adherence to treatment in group sessions, while patients at risk of frailty were visited individually by a geriatrician.
  
  
  RESULTS
  Six hundred and twenty patients were randomized to the IG (49.7%) or to the CG (50.3%), 83.2% completed follow-up. Cox's proportional hazards model showed as covariates the study group (hazard ratio [HR] 0.58; 95% confidence interval [CI] 0.28-1.22), risk of frailty (HR 1.33; 95% CI 0.71-2.51) and the interaction between both (HR 3.08; 95% CI 1.22-7.78). Forty-nine percent of the patients in the IG and 43% in the CG were at risk of frailty at baseline. At the end of the study, 27.9% of the IG and 13.5% of the CG had reversed their initial at risk of frailty status (P = 0.027). Multivariate predictors of reversible risk of frailty were younger age, not being at risk of depression, low consumption of medications and the intervention itself.
  
  
  CONCLUSIONS
  A specific intervention in patients over 74 years attended in primary care reduces morbidity and mortality in patients at risk of frailty and increases the proportion of patients that reversed their initial status at risk of frailty.
authors.affiliation: Research Unit, Sardenya Primary Health Care Centre, Barcelona, Spain. rmonteserin@eapsardenya.cat
authors.forename: Rosa
authors.initials: R
authors.lastname: Monteserin
authors.forename: Carlos
authors.initials: C
authors.lastname: Brotons
authors.forename: Irene
authors.initials: I
authors.lastname: Moral
authors.forename: Salvador
authors.initials: S
authors.lastname: Altimir
authors.forename: Antonio
authors.initials: A
authors.lastname: San José
authors.forename: Sebastián
authors.initials: S
authors.lastname: Santaeugenia
authors.forename: Jaume
authors.initials: J
authors.lastname: Sellarès
authors.forename: Jaume
authors.initials: J
authors.lastname: Padrós
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D009017:Morbidity; D009026:Mortality; D011320:Primary Health Care; D015397:Program Evaluation; D016016:Proportional Hazards Models; D040242:Risk Reduction Behavior; D013030:Spain