Sommers 2000.
| Study characteristics | ||
| Methods | Cluster randomised controlled trial USA |
|
| Participants | 543 participants older than 65 years with at least 2 chronic conditions and living independently, attending 18 private office practices of primary care physicians | |
| Interventions | Senior Care Connections (SCC) intervention delivered by a team including the primary care physician, a nurse with geriatric medicine training and a social worker Home visit assessment followed by team discussion and development of a risk reduction plan and treatment targets | |
| Outcomes |
Primary and secondary (no distinction specified): Physical functioning (Health activities questionnaire (HAQ)) Emotional functioning (short form geriatric depression scale (GDS)) HRQoL (SF36 scores) Social activities count Symptom scale Medication count Nutrition checklist Health service utilisation including office, emergency room and home care visits, hospital admissions, skilled nursing facility admissions, length of hospital stay and nursing home placements Economic: direct costs of the intervention |
|
| Notes | Study duration 2 years, 12‐month follow‐up post completion intervention Comparison: usual care from their primary care physician |
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| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Unclear risk | Study reports "physicians randomised" |
| Allocation concealment (selection bias) | Unclear risk | Unclear at cluster level but no bias at participant level as recruited through clusters |
| Blinding (performance bias and detection bias) All outcomes | Low risk | Healthcare utilisation measured from automated data. |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | 86% follow‐up for service use measures; 74% follow‐up questionnaire data, balanced |
| Selective reporting (reporting bias) | Low risk | None apparent |
| Other bias | Low risk | None apparent |
| Protection against contamination | Low risk | Cluster randomisation |
| Reliable primary outcomes | Low risk | Automated data used and validated measures used |
| Baseline measurement | Low risk | Groups comparable at baseline |