Effects of incorporating multidomain interventions into integrated primary care on quality of life: a randomised controlled trial

作者：Wei‐Ju Lee, Li‐Ning Peng, Chi‐Hung Lin, Ran‐Chou Chen, Shinn‐Zong Lin, Ching‐Hui Loh, Sheng‐Lun Kao, Tzu-Shing Hung, Chia-Yun Chang, Chunfeng Huang, Ting‐Ching Tang, Shih‐Tsung Huang, Yu‐Wen Wen, Fei‐Yuan Hsiao, Liang‐Kung Chen, Hui-Ping Lin, Ming‐Hsien Lin, Ming‐Yueh Chou, Chih‐Kuang Liang, Chu‐Sheng Lin, Li-Kuo Liu, An‐Chun Hwang · 发表于：The Lancet Healthy Longevity · 年份：2021 · DOI：10.1016/s2666-7568(21)00248-8 · 被引用次数：92 · 研究领域：Frailty in Older Adults、Health Promotion and Cardiovascular Prevention、Nutrition and Health in Aging

BACKGROUND: Integrating primary prevention into care pathways for older adults is a core strategy of healthy ageing, but evidence remains limited. We aimed to determine whether incorporating a multidomain intervention into primary health care could improve standard value-based health outcomes and quality of life. METHODS: For this Taiwan Integrated Geriatric Care (TIGER) study, a pragmatic randomised controlled trial, we recruited community-dwelling outpatients aged 65 years or older with at least three chronic medical conditions. We excluded people with malignancies undergoing chemotherapy, people with a life expectancy of less than 12 months, or people who were insufficiently able to communicate with study staff. Participants were randomly assigned (1:1) to usual care or to the integrated multidomain intervention using block randomisation. The integrated multidomain intervention entailed 16 2-h sessions per year, comprising communal physical exercise, cognitive training, nutrition and disease education, plus individualised treatment by specialists in integrated geriatric care. The primary outcome was changes from baseline quality of life, based on 36-item Short Form Health Survey (SF-36) scores, at 3, 6, 9, and 12 months. Intervention effects were analysed per protocol using a generalised linear mixed model. This trial is registered with ClinicalTrials.gov, NCT03528005. FINDINGS: Between June 25, 2018, and Feb 15, 2019, 628 participants were screened, of whom 398 were assig...