Evaluation of the Prevention and Reactivation Care Program (PReCaP) for the hospitalized elderly: a prospective nonrandomized controlled trial

Kirsten J Asmus-Szepesi,1 Linda E Flinterman,1 Marc A Koopmanschap,2 Anna P Nieboer,2 Ton J Bakker,3 Johan P Mackenbach,1 Ewout W Steyerberg1 1Department of Public Health, Erasmus University Medical Center, 2Institute of Health Policy and Management, Erasmus University, 3Stichting Wetenschap Balans...

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Autores principales:	Asmus-Szepesi KJ, Flinterman LE, Koopmanschap MA, Nieboer AP, Bakker TJ, Mackenbach JP, Steyerberg EW
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	functional decline hospitalized elderly geriatric rehabilitation Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/846d0de82f6f4d77afd9731182c93376
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spelling	oai:doaj.org-article:846d0de82f6f4d77afd9731182c933762021-12-02T11:13:19ZEvaluation of the Prevention and Reactivation Care Program (PReCaP) for the hospitalized elderly: a prospective nonrandomized controlled trial1178-1998https://doaj.org/article/846d0de82f6f4d77afd9731182c933762015-03-01T00:00:00Zhttps://www.dovepress.com/evaluation-of-the-prevention-and-reactivation-care-program-precap-for--peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Kirsten J Asmus-Szepesi,1 Linda E Flinterman,1 Marc A Koopmanschap,2 Anna P Nieboer,2 Ton J Bakker,3 Johan P Mackenbach,1 Ewout W Steyerberg1 1Department of Public Health, Erasmus University Medical Center, 2Institute of Health Policy and Management, Erasmus University, 3Stichting Wetenschap Balans, Rotterdam, the Netherlands Background: The hospitalized elderly are at risk of functional decline. We evaluated the effects and care costs of a specialized geriatric rehabilitation program aimed at preventing functional decline among at-risk hospitalized elderly.Methods: The prospective nonrandomized controlled trial reported here was performed in three hospitals in the Netherlands. One hospital implemented the Prevention and Reactivation Care Program (PReCaP), while two other hospitals providing usual care served as control settings. Within the PReCaP hospital we compared patients pre-implementation with patients post-implementation of the PReCaP (“within-hospital analysis”), while our nonrandomized controlled trial compared patients of the PReCaP hospital post-implementation with patients from the two control hospitals providing usual care (“between-hospital analysis”). Hospitalized patients 65 years or older and at risk of functional decline were interviewed at baseline and at 3 and 12 months using validated questionnaires to score functioning, depression, and health-related quality of life (HRQoL). We estimated costs per unit of care from hospital information systems and national data sources. We used adjusted general linear mixed models to analyze functioning and HRQoL.Results: Between-hospital analysis showed no difference in activities of daily living (ADL) or instrumental activities of daily living (IADL) between PReCaP patients and control groups. PReCaP patients did have slightly better cognitive functioning (Mini Mental State Examination; 0.4 [95% confidence interval (CI) 0.2–0.6]), lower depression (Geriatric Depression Scale 15; -0.9 [95% -1.1 to -0.6]) and higher perceived health (Short-Form 20; 5.6 [95% CI 2.8–8.4]) than control patients. Analyses within the PReCaP hospital comparing patients pre- and post-implementation of the PReCaP showed no improvement over time in functioning, depression, and HRQoL. One-year health care costs were higher for PReCaP patients, both for the within-hospital analysis (+€7,000) and the between-hospital analysis (+€2,500).Conclusion: We did not find any effect of the PReCaP on ADL and IADL. The PReCaP may possibly provide some benefits to hospitalized patients at risk of functional decline with respect to cognitive functioning, depression, and perceived health. Further evaluations of integrated intervention programs to limit functional decline are therefore required. Keywords: functional decline, geriatric rehabilitation, health-related quality of life, activities of daily livingAsmus-Szepesi KJFlinterman LEKoopmanschap MANieboer APBakker TJMackenbach JPSteyerberg EWDove Medical Pressarticlefunctional declinehospitalized elderlygeriatric rehabilitationGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 10, Pp 649-661 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	functional decline hospitalized elderly geriatric rehabilitation Geriatrics RC952-954.6
spellingShingle	functional decline hospitalized elderly geriatric rehabilitation Geriatrics RC952-954.6 Asmus-Szepesi KJ Flinterman LE Koopmanschap MA Nieboer AP Bakker TJ Mackenbach JP Steyerberg EW Evaluation of the Prevention and Reactivation Care Program (PReCaP) for the hospitalized elderly: a prospective nonrandomized controlled trial
description	Kirsten J Asmus-Szepesi,1 Linda E Flinterman,1 Marc A Koopmanschap,2 Anna P Nieboer,2 Ton J Bakker,3 Johan P Mackenbach,1 Ewout W Steyerberg1 1Department of Public Health, Erasmus University Medical Center, 2Institute of Health Policy and Management, Erasmus University, 3Stichting Wetenschap Balans, Rotterdam, the Netherlands Background: The hospitalized elderly are at risk of functional decline. We evaluated the effects and care costs of a specialized geriatric rehabilitation program aimed at preventing functional decline among at-risk hospitalized elderly.Methods: The prospective nonrandomized controlled trial reported here was performed in three hospitals in the Netherlands. One hospital implemented the Prevention and Reactivation Care Program (PReCaP), while two other hospitals providing usual care served as control settings. Within the PReCaP hospital we compared patients pre-implementation with patients post-implementation of the PReCaP (“within-hospital analysis”), while our nonrandomized controlled trial compared patients of the PReCaP hospital post-implementation with patients from the two control hospitals providing usual care (“between-hospital analysis”). Hospitalized patients 65 years or older and at risk of functional decline were interviewed at baseline and at 3 and 12 months using validated questionnaires to score functioning, depression, and health-related quality of life (HRQoL). We estimated costs per unit of care from hospital information systems and national data sources. We used adjusted general linear mixed models to analyze functioning and HRQoL.Results: Between-hospital analysis showed no difference in activities of daily living (ADL) or instrumental activities of daily living (IADL) between PReCaP patients and control groups. PReCaP patients did have slightly better cognitive functioning (Mini Mental State Examination; 0.4 [95% confidence interval (CI) 0.2–0.6]), lower depression (Geriatric Depression Scale 15; -0.9 [95% -1.1 to -0.6]) and higher perceived health (Short-Form 20; 5.6 [95% CI 2.8–8.4]) than control patients. Analyses within the PReCaP hospital comparing patients pre- and post-implementation of the PReCaP showed no improvement over time in functioning, depression, and HRQoL. One-year health care costs were higher for PReCaP patients, both for the within-hospital analysis (+€7,000) and the between-hospital analysis (+€2,500).Conclusion: We did not find any effect of the PReCaP on ADL and IADL. The PReCaP may possibly provide some benefits to hospitalized patients at risk of functional decline with respect to cognitive functioning, depression, and perceived health. Further evaluations of integrated intervention programs to limit functional decline are therefore required. Keywords: functional decline, geriatric rehabilitation, health-related quality of life, activities of daily living
format	article
author	Asmus-Szepesi KJ Flinterman LE Koopmanschap MA Nieboer AP Bakker TJ Mackenbach JP Steyerberg EW
author_facet	Asmus-Szepesi KJ Flinterman LE Koopmanschap MA Nieboer AP Bakker TJ Mackenbach JP Steyerberg EW
author_sort	Asmus-Szepesi KJ
title	Evaluation of the Prevention and Reactivation Care Program (PReCaP) for the hospitalized elderly: a prospective nonrandomized controlled trial
title_short	Evaluation of the Prevention and Reactivation Care Program (PReCaP) for the hospitalized elderly: a prospective nonrandomized controlled trial
title_full	Evaluation of the Prevention and Reactivation Care Program (PReCaP) for the hospitalized elderly: a prospective nonrandomized controlled trial
title_fullStr	Evaluation of the Prevention and Reactivation Care Program (PReCaP) for the hospitalized elderly: a prospective nonrandomized controlled trial
title_full_unstemmed	Evaluation of the Prevention and Reactivation Care Program (PReCaP) for the hospitalized elderly: a prospective nonrandomized controlled trial
title_sort	evaluation of the prevention and reactivation care program (precap) for the hospitalized elderly: a prospective nonrandomized controlled trial
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/846d0de82f6f4d77afd9731182c93376
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Evaluation of the Prevention and Reactivation Care Program (PReCaP) for the hospitalized elderly: a prospective nonrandomized controlled trial

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