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  • An outpatient geriatric evaluation and management programme was more effective than usual care in preventing functional decline in high risk older adults

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An outpatient geriatric evaluation and management programme was more effective than usual care in preventing functional decline in high risk older adults

https://doi.org/10.1136/ebn.5.1.19

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    Boult C, Boult LB, Morishita L, et al. A randomized clinical trial of outpatient geriatric evaluation and management.J Am Geriatr Soc2001 Apr;49:351–9OpenUrlCrossRefPubMedWeb of Science

    QUESTIONS: Is an outpatient geriatric evaluation and management (GEM) programme more effective than usual care in preventing functional decline in high risk older adults? Do use and cost of healthcare services differ between groups?

    Design

    Randomised {allocation concealed}*, blinded (outcome assessors), controlled trial with 18 months of follow up.

    Setting

    Ramsey County and adjacent zip codes, Minnesota, USA.

    Patients

    568 patients (mean age 79 y, 56% men, 96% white) who were ≥70 years of age, community dwelling, fee for service Medicare beneficiaries, and at high risk for hospital admission and functional decline. Exclusion criteria included residence in a nursing home, illness requiring frequent physician visits, and communication barriers. Study participants (96%) or their proxies (4%) completed 97% of follow up interviews.

    Intervention

    294 patients were allocated to the GEM team (geriatrician, gerontological nurse practitioner, and social worker) and received an initial home visit, monthly clinic …

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    Footnotes

    • Sources of funding: National Institute on Aging and the Agency for Health Care Policy and Research; the Health Care Financing Administration; the American Academy of Family Physicians Foundation.

    • For correspondence: Dr C Boult, Lipitz Center for Integrated Health Care, Johns Hopkins University, 624 North Broadway Street #653, Baltimore, MD 21205, USA. Fax +1 410 955 0470.

    • A modified version of this abstract appears in Evidence-Based Mental Health