title: Effects of an advanced practice nurse in-home health consultation program for community-dwelling persons aged 80 and older.
abstract: OBJECTIVE
  To evaluate the effects of an advanced practice nurse (APN) in-home health consultation program (HCP) on quality of life, health indicators (falls, acute events), and healthcare utilization.
  
  
  METHODS
  Randomized clinical trial.
  
  
  METHODS
  One urban area in the German-speaking part of Switzerland.
  
  
  METHODS
  Four hundred sixty-one community-dwelling individuals aged 80 and older (mean age 85, 72.7% female, all Caucasian) participated in the intervention (n = 231) and control (n = 230) groups.
  
  
  METHODS
  After a comprehensive geriatric assessment, participants were randomly assigned to the 9-month HCP with four in-home visits and three phone calls from APNs or to a control group with standard care with no intervention.
  
  
  METHODS
  The primary outcome was quality of life at 3, 6, and 9 months. Secondary outcomes were incidence of falls, acute events due to health problems, and healthcare utilization measured for 3-month periods at 3, 6, and 9 months.
  
  
  RESULTS
  The intervention and control groups did not differ significantly on any dimension of the World Health Organization Quality of Life questionnaire but differed significantly over 9 months in self-reported acute events (116 vs 168, relative risk (RR) = 0.70, P = .001), falls (74 vs 101, RR = 0.71, P = .003), consequences of falls (63.1% vs 78.7%, chi-square = 7.39, P = .007), and hospitalizations (47 vs 68, RR = .70, P = .03).
  
  
  CONCLUSIONS
  The in-home HCP provided by APNs and guided by the principles of health promotion, empowerment, partnership, and family-centeredness, can be effective in reducing adverse health outcomes such as falls, acute events, and hospitalizations.
authors.affiliation: School of Health Professions, Institute of Nursing, Zurich University of Applied Sciences, Winterthur, Switzerland. lorenz.imhof@zhaw.ch
authors.forename: Lorenz
authors.initials: L
authors.lastname: Imhof
authors.forename: Rahel
authors.initials: R
authors.lastname: Naef
authors.forename: Margaret I
authors.initials: MI
authors.lastname: Wallhagen
authors.forename: Jürg
authors.initials: J
authors.lastname: Schwarz
authors.forename: Romy
authors.initials: R
authors.lastname: Mahrer-Imhof
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000208:Acute Disease; D057179:Advanced Practice Nursing; D000369:Aged, 80 and over; D003152:Community Health Nursing; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006299:Health Services for the Aged; D006760:Hospitalization; D006801:Humans; D008297:Male; D011788:Quality of Life; D012111:Residence Characteristics