title: A randomized controlled trial of the effect of an intensive 1-year care management program on measures of health status in independent, community-living old elderly: the Eldercare project.
abstract: BACKGROUND
  Primary care practitioners are familiar with the frail elderly and commonly have to deal with their multi-morbidity and their functional decline, both physically and mentally. However, there are well elderly with high quality of life and very few co-morbidities who seldom seek medical care.
  
  
  OBJECTIVE
  To determine if a nurse-based program of home-delivered care, linked directly with the primary care practitioner or primary care team, would improve quality of life, symptoms, satisfaction with care and utilization of community and medical services, in independent community living old elderly.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  St. John's, Newfoundland, Canada.
  
  
  METHODS
  Two hundred and thirty-six independent, community-dwelling, cognitively functioning, people aged 80 years and older.
  
  
  METHODS
  A nurse-based program of care, carried out in the patients home, that involved a detailed assessment of needs, the development of a plan to meet the needs, and up to eight visits to the patients home during a 1-year period to facilitate the meeting of those needs.
  
  
  METHODS
  Usual care
  
  
  METHODS
  Quality of Life measured using the SF-36 and the CASP-19 scales; symptomology using the Comorbidity Symptom Scale; patient satisfaction using the PSQ-18; and assessment of health care services (community services, emergency room visits, hospitalizations, use of diagnostic services and family doctor visits) through patient recall, family physician chart review and assessment of hospitalization records.
  
  
  RESULTS
  There were no statistical or meaningful differences between the intervention and control groups in any of the outcomes measured.
  
  
  CONCLUSIONS
  The intensive, home-delivered, program of care for the well old elderly did not have an impact on the outcomes measured.
authors.affiliation: Family Medicine, godwinm@mun.ca.
authors.forename: Marshall
authors.initials: M
authors.lastname: Godwin
authors.affiliation: Community Health and.
authors.forename: Veeresh
authors.initials: V
authors.lastname: Gadag
authors.affiliation: Family Medicine.
authors.forename: Andrea
authors.initials: A
authors.lastname: Pike
authors.affiliation: Family Medicine.
authors.forename: Heather
authors.initials: H
authors.lastname: Pitcher
authors.affiliation: School of Nursing, Memorial University of Newfoundland, St. John's, Canada.
authors.forename: Karen
authors.initials: K
authors.lastname: Parsons
authors.affiliation: Bliss Murphy Cancer Centre, Eastern Health Authority, St. John's, Canada and.
authors.forename: Farah
authors.initials: F
authors.lastname: McCrate
authors.affiliation: Family Medicine.
authors.forename: Wanda
authors.initials: W
authors.lastname: Parsons
authors.affiliation: Community Health and.
authors.forename: Sharon
authors.initials: S
authors.lastname: Buehler
authors.affiliation: Geriatrics, Windsor regional Hospital, Windsor, Ontario, Canada.
authors.forename: Anne
authors.initials: A
authors.lastname: Sclater
authors.affiliation: Family Medicine.
authors.forename: Robert
authors.initials: R
authors.lastname: Miller
mesh_terms: D000369:Aged, 80 and over; D002170:Canada; D003153:Community Health Services / Q000706:statistics & numerical data; D005260:Female; D016330:Frail Elderly; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006304:Health Status; D006699:Home Care Services; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D057187:Independent Living; D008297:Male; D020380:Needs Assessment; D017060:Patient Satisfaction; D057184:Practice Patterns, Nurses'; D059017:Primary Care Nursing / Q000379:methods*; D011788:Quality of Life
keywords: Aging; Geriatrics; Health promotion; Nursing; Primary care; Quality of life.