ELDERLY, GERIATRIC ASSESSMENT - IMPROVES FUNCTIONAL STATUS AND DECREASES NURSING HOME ADMISSIONS

The Study:
Single-blinded randomised controlled trial without intention-to-treat.
patients > 75 years of age who lived at home
Control group (N = 199; 199 analysed): usual care by their usual physicians
Experimental group (N = 215; 215 analysed): annual assessments in their homes from gerontologic nurse practitioners-assessments included medical history, physicial exam, lab tests; determinations of functional and mental status, oral health, gait and balance, medications, vision, hearing, social network and support, home safety and external access

The Evidence:

Outcome	Time to Outcome	CER	EER	RRR	ARR	NNT
long-term nursing home admission	3 years	0.101	0.042	58%	0.059	17
95% Confidence Intervals:				9% to 100%	0.009 to 0.109	9 to 108
admission to acute care hospital	3 years	0.467	0.460	1%	0.007	143
95% Confidence Intervals:				-19% to 22%	-0.089 to 0.103	NNT = 10 to INF NNH = 11 to INF;

1. cost of intervention included but may differ according to your location
2. these patients had higher education level and lower mortality rate and lower rate of acute care hospital admission -therefore need to compare this to your won population to assess applicability
3. uncertain which components of the geriatric assessment are the most important and have the greatest impact on maintaining independence

Appraised by Straus 1998; Expiry date: 1999

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