A clinical trial of nurse practitioner care in residential aged care facilities

Glenn Arendts, Pamela Deans, Keith O'Brien, Christopher Etherton-Beer, Kirsten Howard, Gill Lewin, Moira Sim

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Optimising quality of life and reducing hospitalisation for people living in residential aged care facilities (RACF) are important health policy goals. Methods: A cluster controlled clinical trial of nurse practitioner care in RACF. Six facilities were included: three randomly allocated to intervention where nurse practitioners working with general practitioners and using a best practice guide were responsible for care, and three control. Participants were followed up for a minimum of 12 months unless dead or transferred to another facility. Results: We enrolled two hundred patients (101 intervention and 99 control) with a mean (SD) follow up of 604 (276) days. There were 98 ED visits by intervention participants, resulting in 56 hospitalisations, compared with 121 ED visits and 70 hospitalisations for controls (risk reduction = 8%, 95% CI = −1% −17%, p = 0.10). For the pre-specified secondary outcomes of transfers within the first 12 months of enrolment, the number of residents making at least one visit (46 in each study arm) and rate of ED attendance (0.66 visits per intervention resident versus 0.70 visits per control resident) was not affected by the intervention. After adjusting for dependency and comorbidity, the intervention group had non-significantly lower transfers (OR 0.7, 95% CI 0.3-1.5, p = 0.34). There was a reduction in the rate of decline in the quality of life of intervention compared to control residents. Conclusions: Nurse practitioner care coordination resulted in no statistically significant change in rates of ED transfer or health care utilisation, but better maintained resident quality of life.

Original languageEnglish
Pages (from-to)129-132
Number of pages4
JournalArchives of Gerontology and Geriatrics
Volume77
DOIs
Publication statusPublished - 1 Jul 2018

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Nurse Practitioners
Hospitalization
nurse
Quality of Life
Clinical Trials
resident
Patient Acceptance of Health Care
hospitalization
Controlled Clinical Trials
quality of life
Risk Reduction Behavior
Health Policy
Practice Guidelines
General Practitioners
Comorbidity
comorbidity
general practitioner
health policy
best practice
utilization

Cite this

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title = "A clinical trial of nurse practitioner care in residential aged care facilities",
abstract = "Background: Optimising quality of life and reducing hospitalisation for people living in residential aged care facilities (RACF) are important health policy goals. Methods: A cluster controlled clinical trial of nurse practitioner care in RACF. Six facilities were included: three randomly allocated to intervention where nurse practitioners working with general practitioners and using a best practice guide were responsible for care, and three control. Participants were followed up for a minimum of 12 months unless dead or transferred to another facility. Results: We enrolled two hundred patients (101 intervention and 99 control) with a mean (SD) follow up of 604 (276) days. There were 98 ED visits by intervention participants, resulting in 56 hospitalisations, compared with 121 ED visits and 70 hospitalisations for controls (risk reduction = 8{\%}, 95{\%} CI = −1{\%} −17{\%}, p = 0.10). For the pre-specified secondary outcomes of transfers within the first 12 months of enrolment, the number of residents making at least one visit (46 in each study arm) and rate of ED attendance (0.66 visits per intervention resident versus 0.70 visits per control resident) was not affected by the intervention. After adjusting for dependency and comorbidity, the intervention group had non-significantly lower transfers (OR 0.7, 95{\%} CI 0.3-1.5, p = 0.34). There was a reduction in the rate of decline in the quality of life of intervention compared to control residents. Conclusions: Nurse practitioner care coordination resulted in no statistically significant change in rates of ED transfer or health care utilisation, but better maintained resident quality of life.",
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A clinical trial of nurse practitioner care in residential aged care facilities. / Arendts, Glenn; Deans, Pamela; O'Brien, Keith; Etherton-Beer, Christopher; Howard, Kirsten; Lewin, Gill; Sim, Moira.

In: Archives of Gerontology and Geriatrics, Vol. 77, 01.07.2018, p. 129-132.

Research output: Contribution to journalArticle

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T1 - A clinical trial of nurse practitioner care in residential aged care facilities

AU - Arendts, Glenn

AU - Deans, Pamela

AU - O'Brien, Keith

AU - Etherton-Beer, Christopher

AU - Howard, Kirsten

AU - Lewin, Gill

AU - Sim, Moira

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