RT Journal Article
SR Electronic
T1 Combining volunteers and primary care teamwork to support health goals and needs of older adults: a pragmatic randomized controlled trial
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP E491
OP E500
DO 10.1503/cmaj.181173
VO 191
IS 18
A1 Dolovich, Lisa
A1 Oliver, Doug
A1 Lamarche, Larkin
A1 Thabane, Lehana
A1 Valaitis, Ruta
A1 Agarwal, Gina
A1 Carr, Tracey
A1 Foster, Gary
A1 Griffith, Lauren
A1 Javadi, Dena
A1 Kastner, Monika
A1 Mangin, Dee
A1 Papaioannou, Alexandra
A1 Ploeg, Jenny
A1 Raina, Parminder
A1 Richardson, Julie
A1 Risdon, Cathy
A1 Santaguida, Pasqualina
A1 Straus, Sharon
A1 Price, David
YR 2019
UL http://www.cmaj.ca/content/191/18/E491.abstract
AB BACKGROUND: The Health TAPESTRY (Health Teams Advancing Patient Experience: STRengthening QualitY) intervention was designed to improve primary care teamwork and promote optimal aging. We evaluated the effectiveness of Health TAPESTRY in attaining goals of older adults (e.g., physical activity, productivity, social connection, medical status) and other outcomes.METHODS: We conducted a pragmatic randomized controlled trial between January and October 2015 in a primary care practice in Hamilton, Ontario. Older adults were randomized (1:1) to Health TAPESTRY (n = 158) or control (n = 154). Trained community volunteers gathered information on people’s goals, needs and risks in their homes, using electronic forms. Interprofessional primary care teams reviewed summaries and addressed issues. Participants reported goal attainment (primary outcome), self-efficacy, quality of life, optimal aging, social support, empowerment, physical activity, falls, and access to and comprehensiveness of the health system. We determined use of health care resources through chart audit.RESULTS: There were no differences between groups in goal attainment or many other patient-reported outcome and experience assessments at 6 months. More primary care visits took place in the intervention versus control group over 6 months (mean ± standard deviation [SD] 4.93 ± 3.86 v. 3.50 ± 3.53; difference of 1.52 [95% confidence interval (CI) 0.84 to 2.19]). The odds of having 1 or more hospital admission were lower for the intervention group (odds ratio [OR] 0.44 [95% CI 0.20 to 0.95]).INTERPRETATION: Health TAPESTRY did not improve the primary outcome of goal attainment but showed signals of shifting care from reactive to active preventive care. Further evaluation will help in understanding effective components, costs and consequences of the intervention. Trial registration: ClinicalTrials.gov, no. NCT02283723See related article at www.cmaj.ca/lookup/doi/10.1503/cmaj.190406