The MRC trial of assessment and management of older people in the community: objectives, design and interventions [ISRCTN23494848].
The MRC trial of assessment and management of older people in the community: objectives, design and interventions [ISRCTN23494848].
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DOI：
10.1186/1472-6963-2-21
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发表时间：
2002-10-25
影响因子：
2.8
通讯作者：
Tulloch AJ
中科院分区：
文献类型：
--
作者：
Fletcher AE;Jones DA;Bulpitt CJ;Tulloch AJ
定期对老年人进行多维评估的益处仍然存在争议。大多数试验规模太小，无法产生足够的证据来为政策提供信息。尽管缺乏可靠的证据基础，英国初级保健医生（全科医生）仍被要求为75岁及以上的患者提供年度健康检查。初级保健中的聚类随机因子试验，比较一揽子评估(i)普遍评估与目标评估和（ii）初级保健团队（PC）或多学科老年评估团队（GM）的管理。随机化的单位是一般实践。75岁及以上的老年人有资格参加75岁以上的健康检查，但不包括那些住在养老院或身患绝症的人。所有参与者都会收到一个简短的评估，涵盖75分以上的所有领域。在通用组中，所有参与者还接受一名研究护士的详细健康和社会评估，而在目标组中，只有在简短评估中预先确定了问题数量和范围的参与者才能继续接受详细评估。研究护士根据详细评估的结果和反应遵循标准方案，转介给(i)随机管理团队（PC或GM） （ii）其他医疗服务，卫生保健工作者或机构（iii）紧急转介给全科医生。主要结果是死亡率、住院和住院率以及生活质量。106家诊所和33,000名老年人被招募参加了这项试验。
The benefit of regular multidimensional assessment of older people remains controversial. The majority of trials have been too small to produce adequate evidence to inform policy. Despite the lack of a firm evidence base, UK primary care practitioners (general practitioners) are required to offer an annual health check to patients aged 75 years and over. Cluster-randomised factorial trial in primary care comparing a package of assessments (i) universal versus targeted assessment and (ii) management by the primary care team (PC) or a multidisciplinary geriatric assessment team (GM). The unit of randomization is the general practice. Older people aged 75 and over eligible for the over 75s health check and excluding those in nursing homes or terminally ill were invited to participate. All participants receive a brief assessment covering all areas of the over 75s check. In the universal arm all participants also receive a detailed health and social assessment by a study nurse while in the targeted arm only participants with a pre-determined number and range of problems at the brief assessment go on to have the detailed assessment. The study nurse follows a standard protocol based on results and responses in the detailed assessment to make referrals to (i) the randomised management team (PC or GM) (ii) other medical services, health care workers or agencies (iii) emergency referrals to the GP. The main outcomes are mortality, hospital and institutional admissions and quality of life. 106 practices and 33,000 older people have been recruited to the trial.
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影响因子：
2
作者：
HSIEH, FY
通讯作者：
HSIEH, FY
影响因子：
3
作者：
BERGNER, M;BOBBITT, RA;GILSON, BS
通讯作者：
GILSON, BS
影响因子：
168.9
作者：
STUCK, AE;SIU, AL;RUBENSTEIN, LZ
通讯作者：
RUBENSTEIN, LZ
影响因子：
7.7
作者：
SHIPLEY, MJ;SMITH, PG;DRAMAIX, M
通讯作者：
DRAMAIX, M
影响因子：
7.7
作者：
BULPITT, CJ;SHIPLEY, MJ;ROSE, G
通讯作者：
ROSE, G