The MRC trial of assessment and management of older people in the community: objectives, design and interventions [ISRCTN23494848]


Fletcher, AE; Jones, DA; Bulpitt, CJ; Tulloch, AJ; (2002) The MRC trial of assessment and management of older people in the community: objectives, design and interventions [ISRCTN23494848]. BMC Health Serv Res, 2 (1). p. 21. ISSN 1472-6963

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Abstract

BACKGROUND: The benefit of regular multidimensional assessment of older people remains controversial. The majority of trials have been too small to produce adequate evidence to inform policy. Despite the lack of a firm evidence base, UK primary care practitioners (general practitioners) are required to offer an annual health check to patients aged 75 years and over. DESIGN: Cluster-randomised factorial trial in primary care comparing a package of assessments (i) universal versus targeted assessment and (ii) management by the primary care team (PC) or a multidisciplinary geriatric assessment team (GM). The unit of randomization is the general practice. METHODS: Older people aged 75 and over eligible for the over 75s health check and excluding those in nursing homes or terminally ill were invited to participate. All participants receive a brief assessment covering all areas of the over 75s check. In the universal arm all participants also receive a detailed health and social assessment by a study nurse while in the targeted arm only participants with a pre-determined number and range of problems at the brief assessment go on to have the detailed assessment. The study nurse follows a standard protocol based on results and responses in the detailed assessment to make referrals to (i) the randomised management team (PC or GM) (ii) other medical services, health care workers or agencies (iii) emergency referrals to the GP. The main outcomes are mortality, hospital and institutional admissions and quality of life. 106 practices and 33,000 older people have been recruited to the trial.

Item Type: Article
Keywords: Aged, Aged, 80 and over, Cluster Analysis, Family Practice/legislation & jurisprudence/*standards, Geriatric Assessment/*methods, Great Britain/epidemiology, Hospitalization/statistics & numerical data, Human, Mortality, *Patient Care Team, Physical Examination/*methods, Primary Health Care/legislation & jurisprudence/*standards, Quality of Life, Questionnaires, Referral and Consultation, State Medicine/legislation & jurisprudence/standards, Support, Non-U.S. Gov't, Aged, Aged, 80 and over, Cluster Analysis, Family Practice, legislation & jurisprudence, standards, Geriatric Assessment, methods, Great Britain, epidemiology, Hospitalization, statistics & numerical data, Human, Mortality, Patient Care Team, Physical Examination, methods, Primary Health Care, legislation & jurisprudence, standards, Quality of Life, Questionnaires, Referral and Consultation, State Medicine, legislation & jurisprudence, standards, Support, Non-U.S. Gov't
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Non-Communicable Disease Epidemiology
PubMed ID: 12398790
Web of Science ID: 180222700001
URI: http://researchonline.lshtm.ac.uk/id/eprint/17016

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