[Meagre evidence so far for effectiveness of in-home comprehensive geriatric assessment: a literature review].
BACKGROUND
Most elderly people attach great value to staying functionally independent for as long as possible. A targeted detection and treatment of factors that threaten functional independence, through comprehensive geriatric assessment, might promote this. This paper describes a review on the effect of in-home comprehensive geriatric assessment.


METHODS
A search was carried out in Pubmed (1977-2012) for randomized controlled trials investigating the effectiveness of multidisciplinary multidimensional in-home geriatric assessment. Data was extracted about effectiveness, costs and factors that had a positive or negative influence on the outcome of CGA.


RESULTS
Nine RCTs could be included in the study. All studies were of moderate to good quality, except for one study of poor quality. A positive effect was found in three out of six studies on functional status and in two out of four studies on quality of life. No effect was found on number of hospital admissions, nursing home admissions and on mortality. Most studies showed a rise in total health care expenditure.


CONCLUSIONS
In-home CGA has a modest positive effect on functional status and quality of life. Evidence suggest that in-home CGA might be most effective in elderly that have a relatively high level of functioning.
Ouderengeneeskunde Birkhoven Zorggoed, Amersfoort, The Netherlands, e.mulligen@birkhovenzorggoed.nl.
E C M
EC
van Mulligen-van de Belt
M
M
Smalbrugge
M F I A
MF
Depla
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D003362:Cost-Benefit Analysis; D019317:Evidence-Based Medicine; D015577:Geriatric Assessment / Q000379:methods; D017048:Health Care Costs; D006299:Health Services for the Aged / Q000191:economics / Q000592:standards*; D006699:Home Care Services / Q000191:economics / Q000592:standards*; D006801:Humans; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic