Combining volunteers and primary care teamwork to support health goals and needs of older adults: a pragmatic randomized controlled trial.

Accidental Falls / prevention & control Aged / psychology Exercise Goals Health Services Needs and Demand Health Services for the Aged / organization & administration Humans Patient Care Team Patient Reported Outcome Measures Preventive Health Services Primary Health Care / organization & administration Quality of Life Self Efficacy Social Support Volunteers

Journal

CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
ISSN: 1488-2329
Titre abrégé: CMAJ
Pays: Canada
ID NLM: 9711805

Informations de publication

Date de publication:
06 05 2019
Historique:
accepted: 08 04 2019
entrez: 8 5 2019
pubmed: 8 5 2019
medline: 14 2 2020
Statut: ppublish

Résumé

The Health TAPESTRY (Health Teams Advancing Patient Experience: STRengthening QualitY) intervention was designed to improve primary care teamwork and promote optimal aging. We evaluated the effectiveness of Health TAPESTRY in attaining goals of older adults (e.g., physical activity, productivity, social connection, medical status) and other outcomes. We conducted a pragmatic randomized controlled trial between January and October 2015 in a primary care practice in Hamilton, Ontario. Older adults were randomized (1:1) to Health TAPESTRY ( There were no differences between groups in goal attainment or many other patient-reported outcome and experience assessments at 6 months. More primary care visits took place in the intervention versus control group over 6 months (mean ± standard deviation [SD] 4.93 ± 3.86 v. 3.50 ± 3.53; difference of 1.52 [95% confidence interval (CI) 0.84 to 2.19]). The odds of having 1 or more hospital admission were lower for the intervention group (odds ratio [OR] 0.44 [95% CI 0.20 to 0.95]). Health TAPESTRY did not improve the primary outcome of goal attainment but showed signals of shifting care from reactive to active preventive care. Further evaluation will help in understanding effective components, costs and consequences of the intervention.

Sections du résumé

BACKGROUND
The Health TAPESTRY (Health Teams Advancing Patient Experience: STRengthening QualitY) intervention was designed to improve primary care teamwork and promote optimal aging. We evaluated the effectiveness of Health TAPESTRY in attaining goals of older adults (e.g., physical activity, productivity, social connection, medical status) and other outcomes.
METHODS
We conducted a pragmatic randomized controlled trial between January and October 2015 in a primary care practice in Hamilton, Ontario. Older adults were randomized (1:1) to Health TAPESTRY (
RESULTS
There were no differences between groups in goal attainment or many other patient-reported outcome and experience assessments at 6 months. More primary care visits took place in the intervention versus control group over 6 months (mean ± standard deviation [SD] 4.93 ± 3.86 v. 3.50 ± 3.53; difference of 1.52 [95% confidence interval (CI) 0.84 to 2.19]). The odds of having 1 or more hospital admission were lower for the intervention group (odds ratio [OR] 0.44 [95% CI 0.20 to 0.95]).
INTERPRETATION
Health TAPESTRY did not improve the primary outcome of goal attainment but showed signals of shifting care from reactive to active preventive care. Further evaluation will help in understanding effective components, costs and consequences of the intervention.

Identifiants

DOI: 10.1503/cmaj.181173 PMID: 31061074 PMC: PMC6509035
pubmed: 31061074
pii: 191/18/E491
doi: 10.1503/cmaj.181173
pmc: PMC6509035
doi:

Banques de données

ClinicalTrials.gov
['NCT02283723']

Types de publication

Journal Article Pragmatic Clinical Trial Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

E491-E500

Commentaires et corrections

Type : CommentIn

Informations de copyright

© 2019 Joule Inc. or its licensors.

Déclaration de conflit d'intérêts

Competing interests: Tracey Carr, Lisa Dolovich, Dee Mangin, David Price and Cathy Risdon report receiving grants from Health Canada and the Government of Ontario during the conduct of this study.

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Auteurs

Lisa Dolovich (L)

Departments of Family Medicine (Dolovich, Oliver, Lamarche, Agarwal, Carr, Javadi, Mangin, Risdon, Price), Medicine (Papaioannou), and Health Research Methods, Evidence and Impact (Thabane, Foster, Griffith, Raina, Santaguida, Papaioannou), McMaster Institute for Research on Aging (Raina), Schools of Rehabilitation Science (Richardson) and of Nursing (Valaitis, Ploeg), McMaster University; Hamilton Health Sciences (Price), Hamilton, Ont.; Leslie Dan Faculty of Pharmacy (Dolovich); University of Toronto; Institute of Health Policy, Management and Evaluation (Kastner), Dalla Lana School of Public Health, University of Toronto; Li Ka Shing Knowledge Institute of St. Michael's Hospital (Straus), Toronto, Ont. lisa.dolovich@utoronto.ca.

Doug Oliver (D)

Departments of Family Medicine (Dolovich, Oliver, Lamarche, Agarwal, Carr, Javadi, Mangin, Risdon, Price), Medicine (Papaioannou), and Health Research Methods, Evidence and Impact (Thabane, Foster, Griffith, Raina, Santaguida, Papaioannou), McMaster Institute for Research on Aging (Raina), Schools of Rehabilitation Science (Richardson) and of Nursing (Valaitis, Ploeg), McMaster University; Hamilton Health Sciences (Price), Hamilton, Ont.; Leslie Dan Faculty of Pharmacy (Dolovich); University of Toronto; Institute of Health Policy, Management and Evaluation (Kastner), Dalla Lana School of Public Health, University of Toronto; Li Ka Shing Knowledge Institute of St. Michael's Hospital (Straus), Toronto, Ont.

Larkin Lamarche (L)

Departments of Family Medicine (Dolovich, Oliver, Lamarche, Agarwal, Carr, Javadi, Mangin, Risdon, Price), Medicine (Papaioannou), and Health Research Methods, Evidence and Impact (Thabane, Foster, Griffith, Raina, Santaguida, Papaioannou), McMaster Institute for Research on Aging (Raina), Schools of Rehabilitation Science (Richardson) and of Nursing (Valaitis, Ploeg), McMaster University; Hamilton Health Sciences (Price), Hamilton, Ont.; Leslie Dan Faculty of Pharmacy (Dolovich); University of Toronto; Institute of Health Policy, Management and Evaluation (Kastner), Dalla Lana School of Public Health, University of Toronto; Li Ka Shing Knowledge Institute of St. Michael's Hospital (Straus), Toronto, Ont.

Lehana Thabane (L)

Departments of Family Medicine (Dolovich, Oliver, Lamarche, Agarwal, Carr, Javadi, Mangin, Risdon, Price), Medicine (Papaioannou), and Health Research Methods, Evidence and Impact (Thabane, Foster, Griffith, Raina, Santaguida, Papaioannou), McMaster Institute for Research on Aging (Raina), Schools of Rehabilitation Science (Richardson) and of Nursing (Valaitis, Ploeg), McMaster University; Hamilton Health Sciences (Price), Hamilton, Ont.; Leslie Dan Faculty of Pharmacy (Dolovich); University of Toronto; Institute of Health Policy, Management and Evaluation (Kastner), Dalla Lana School of Public Health, University of Toronto; Li Ka Shing Knowledge Institute of St. Michael's Hospital (Straus), Toronto, Ont.

Ruta Valaitis (R)

Departments of Family Medicine (Dolovich, Oliver, Lamarche, Agarwal, Carr, Javadi, Mangin, Risdon, Price), Medicine (Papaioannou), and Health Research Methods, Evidence and Impact (Thabane, Foster, Griffith, Raina, Santaguida, Papaioannou), McMaster Institute for Research on Aging (Raina), Schools of Rehabilitation Science (Richardson) and of Nursing (Valaitis, Ploeg), McMaster University; Hamilton Health Sciences (Price), Hamilton, Ont.; Leslie Dan Faculty of Pharmacy (Dolovich); University of Toronto; Institute of Health Policy, Management and Evaluation (Kastner), Dalla Lana School of Public Health, University of Toronto; Li Ka Shing Knowledge Institute of St. Michael's Hospital (Straus), Toronto, Ont.

Gina Agarwal (G)

Departments of Family Medicine (Dolovich, Oliver, Lamarche, Agarwal, Carr, Javadi, Mangin, Risdon, Price), Medicine (Papaioannou), and Health Research Methods, Evidence and Impact (Thabane, Foster, Griffith, Raina, Santaguida, Papaioannou), McMaster Institute for Research on Aging (Raina), Schools of Rehabilitation Science (Richardson) and of Nursing (Valaitis, Ploeg), McMaster University; Hamilton Health Sciences (Price), Hamilton, Ont.; Leslie Dan Faculty of Pharmacy (Dolovich); University of Toronto; Institute of Health Policy, Management and Evaluation (Kastner), Dalla Lana School of Public Health, University of Toronto; Li Ka Shing Knowledge Institute of St. Michael's Hospital (Straus), Toronto, Ont.

Tracey Carr (T)

Departments of Family Medicine (Dolovich, Oliver, Lamarche, Agarwal, Carr, Javadi, Mangin, Risdon, Price), Medicine (Papaioannou), and Health Research Methods, Evidence and Impact (Thabane, Foster, Griffith, Raina, Santaguida, Papaioannou), McMaster Institute for Research on Aging (Raina), Schools of Rehabilitation Science (Richardson) and of Nursing (Valaitis, Ploeg), McMaster University; Hamilton Health Sciences (Price), Hamilton, Ont.; Leslie Dan Faculty of Pharmacy (Dolovich); University of Toronto; Institute of Health Policy, Management and Evaluation (Kastner), Dalla Lana School of Public Health, University of Toronto; Li Ka Shing Knowledge Institute of St. Michael's Hospital (Straus), Toronto, Ont.

Gary Foster (G)

Departments of Family Medicine (Dolovich, Oliver, Lamarche, Agarwal, Carr, Javadi, Mangin, Risdon, Price), Medicine (Papaioannou), and Health Research Methods, Evidence and Impact (Thabane, Foster, Griffith, Raina, Santaguida, Papaioannou), McMaster Institute for Research on Aging (Raina), Schools of Rehabilitation Science (Richardson) and of Nursing (Valaitis, Ploeg), McMaster University; Hamilton Health Sciences (Price), Hamilton, Ont.; Leslie Dan Faculty of Pharmacy (Dolovich); University of Toronto; Institute of Health Policy, Management and Evaluation (Kastner), Dalla Lana School of Public Health, University of Toronto; Li Ka Shing Knowledge Institute of St. Michael's Hospital (Straus), Toronto, Ont.

Lauren Griffith (L)

Departments of Family Medicine (Dolovich, Oliver, Lamarche, Agarwal, Carr, Javadi, Mangin, Risdon, Price), Medicine (Papaioannou), and Health Research Methods, Evidence and Impact (Thabane, Foster, Griffith, Raina, Santaguida, Papaioannou), McMaster Institute for Research on Aging (Raina), Schools of Rehabilitation Science (Richardson) and of Nursing (Valaitis, Ploeg), McMaster University; Hamilton Health Sciences (Price), Hamilton, Ont.; Leslie Dan Faculty of Pharmacy (Dolovich); University of Toronto; Institute of Health Policy, Management and Evaluation (Kastner), Dalla Lana School of Public Health, University of Toronto; Li Ka Shing Knowledge Institute of St. Michael's Hospital (Straus), Toronto, Ont.

Dena Javadi (D)

Departments of Family Medicine (Dolovich, Oliver, Lamarche, Agarwal, Carr, Javadi, Mangin, Risdon, Price), Medicine (Papaioannou), and Health Research Methods, Evidence and Impact (Thabane, Foster, Griffith, Raina, Santaguida, Papaioannou), McMaster Institute for Research on Aging (Raina), Schools of Rehabilitation Science (Richardson) and of Nursing (Valaitis, Ploeg), McMaster University; Hamilton Health Sciences (Price), Hamilton, Ont.; Leslie Dan Faculty of Pharmacy (Dolovich); University of Toronto; Institute of Health Policy, Management and Evaluation (Kastner), Dalla Lana School of Public Health, University of Toronto; Li Ka Shing Knowledge Institute of St. Michael's Hospital (Straus), Toronto, Ont.

Monika Kastner (M)

Departments of Family Medicine (Dolovich, Oliver, Lamarche, Agarwal, Carr, Javadi, Mangin, Risdon, Price), Medicine (Papaioannou), and Health Research Methods, Evidence and Impact (Thabane, Foster, Griffith, Raina, Santaguida, Papaioannou), McMaster Institute for Research on Aging (Raina), Schools of Rehabilitation Science (Richardson) and of Nursing (Valaitis, Ploeg), McMaster University; Hamilton Health Sciences (Price), Hamilton, Ont.; Leslie Dan Faculty of Pharmacy (Dolovich); University of Toronto; Institute of Health Policy, Management and Evaluation (Kastner), Dalla Lana School of Public Health, University of Toronto; Li Ka Shing Knowledge Institute of St. Michael's Hospital (Straus), Toronto, Ont.

Dee Mangin (D)

Departments of Family Medicine (Dolovich, Oliver, Lamarche, Agarwal, Carr, Javadi, Mangin, Risdon, Price), Medicine (Papaioannou), and Health Research Methods, Evidence and Impact (Thabane, Foster, Griffith, Raina, Santaguida, Papaioannou), McMaster Institute for Research on Aging (Raina), Schools of Rehabilitation Science (Richardson) and of Nursing (Valaitis, Ploeg), McMaster University; Hamilton Health Sciences (Price), Hamilton, Ont.; Leslie Dan Faculty of Pharmacy (Dolovich); University of Toronto; Institute of Health Policy, Management and Evaluation (Kastner), Dalla Lana School of Public Health, University of Toronto; Li Ka Shing Knowledge Institute of St. Michael's Hospital (Straus), Toronto, Ont.

Alexandra Papaioannou (A)

Departments of Family Medicine (Dolovich, Oliver, Lamarche, Agarwal, Carr, Javadi, Mangin, Risdon, Price), Medicine (Papaioannou), and Health Research Methods, Evidence and Impact (Thabane, Foster, Griffith, Raina, Santaguida, Papaioannou), McMaster Institute for Research on Aging (Raina), Schools of Rehabilitation Science (Richardson) and of Nursing (Valaitis, Ploeg), McMaster University; Hamilton Health Sciences (Price), Hamilton, Ont.; Leslie Dan Faculty of Pharmacy (Dolovich); University of Toronto; Institute of Health Policy, Management and Evaluation (Kastner), Dalla Lana School of Public Health, University of Toronto; Li Ka Shing Knowledge Institute of St. Michael's Hospital (Straus), Toronto, Ont.

Jenny Ploeg (J)

Departments of Family Medicine (Dolovich, Oliver, Lamarche, Agarwal, Carr, Javadi, Mangin, Risdon, Price), Medicine (Papaioannou), and Health Research Methods, Evidence and Impact (Thabane, Foster, Griffith, Raina, Santaguida, Papaioannou), McMaster Institute for Research on Aging (Raina), Schools of Rehabilitation Science (Richardson) and of Nursing (Valaitis, Ploeg), McMaster University; Hamilton Health Sciences (Price), Hamilton, Ont.; Leslie Dan Faculty of Pharmacy (Dolovich); University of Toronto; Institute of Health Policy, Management and Evaluation (Kastner), Dalla Lana School of Public Health, University of Toronto; Li Ka Shing Knowledge Institute of St. Michael's Hospital (Straus), Toronto, Ont.

Parminder Raina (P)

Departments of Family Medicine (Dolovich, Oliver, Lamarche, Agarwal, Carr, Javadi, Mangin, Risdon, Price), Medicine (Papaioannou), and Health Research Methods, Evidence and Impact (Thabane, Foster, Griffith, Raina, Santaguida, Papaioannou), McMaster Institute for Research on Aging (Raina), Schools of Rehabilitation Science (Richardson) and of Nursing (Valaitis, Ploeg), McMaster University; Hamilton Health Sciences (Price), Hamilton, Ont.; Leslie Dan Faculty of Pharmacy (Dolovich); University of Toronto; Institute of Health Policy, Management and Evaluation (Kastner), Dalla Lana School of Public Health, University of Toronto; Li Ka Shing Knowledge Institute of St. Michael's Hospital (Straus), Toronto, Ont.

Julie Richardson (J)

Departments of Family Medicine (Dolovich, Oliver, Lamarche, Agarwal, Carr, Javadi, Mangin, Risdon, Price), Medicine (Papaioannou), and Health Research Methods, Evidence and Impact (Thabane, Foster, Griffith, Raina, Santaguida, Papaioannou), McMaster Institute for Research on Aging (Raina), Schools of Rehabilitation Science (Richardson) and of Nursing (Valaitis, Ploeg), McMaster University; Hamilton Health Sciences (Price), Hamilton, Ont.; Leslie Dan Faculty of Pharmacy (Dolovich); University of Toronto; Institute of Health Policy, Management and Evaluation (Kastner), Dalla Lana School of Public Health, University of Toronto; Li Ka Shing Knowledge Institute of St. Michael's Hospital (Straus), Toronto, Ont.

Cathy Risdon (C)

Departments of Family Medicine (Dolovich, Oliver, Lamarche, Agarwal, Carr, Javadi, Mangin, Risdon, Price), Medicine (Papaioannou), and Health Research Methods, Evidence and Impact (Thabane, Foster, Griffith, Raina, Santaguida, Papaioannou), McMaster Institute for Research on Aging (Raina), Schools of Rehabilitation Science (Richardson) and of Nursing (Valaitis, Ploeg), McMaster University; Hamilton Health Sciences (Price), Hamilton, Ont.; Leslie Dan Faculty of Pharmacy (Dolovich); University of Toronto; Institute of Health Policy, Management and Evaluation (Kastner), Dalla Lana School of Public Health, University of Toronto; Li Ka Shing Knowledge Institute of St. Michael's Hospital (Straus), Toronto, Ont.

Pasqualina Santaguida (P)

Departments of Family Medicine (Dolovich, Oliver, Lamarche, Agarwal, Carr, Javadi, Mangin, Risdon, Price), Medicine (Papaioannou), and Health Research Methods, Evidence and Impact (Thabane, Foster, Griffith, Raina, Santaguida, Papaioannou), McMaster Institute for Research on Aging (Raina), Schools of Rehabilitation Science (Richardson) and of Nursing (Valaitis, Ploeg), McMaster University; Hamilton Health Sciences (Price), Hamilton, Ont.; Leslie Dan Faculty of Pharmacy (Dolovich); University of Toronto; Institute of Health Policy, Management and Evaluation (Kastner), Dalla Lana School of Public Health, University of Toronto; Li Ka Shing Knowledge Institute of St. Michael's Hospital (Straus), Toronto, Ont.

Sharon Straus (S)

Departments of Family Medicine (Dolovich, Oliver, Lamarche, Agarwal, Carr, Javadi, Mangin, Risdon, Price), Medicine (Papaioannou), and Health Research Methods, Evidence and Impact (Thabane, Foster, Griffith, Raina, Santaguida, Papaioannou), McMaster Institute for Research on Aging (Raina), Schools of Rehabilitation Science (Richardson) and of Nursing (Valaitis, Ploeg), McMaster University; Hamilton Health Sciences (Price), Hamilton, Ont.; Leslie Dan Faculty of Pharmacy (Dolovich); University of Toronto; Institute of Health Policy, Management and Evaluation (Kastner), Dalla Lana School of Public Health, University of Toronto; Li Ka Shing Knowledge Institute of St. Michael's Hospital (Straus), Toronto, Ont.

David Price (D)

Departments of Family Medicine (Dolovich, Oliver, Lamarche, Agarwal, Carr, Javadi, Mangin, Risdon, Price), Medicine (Papaioannou), and Health Research Methods, Evidence and Impact (Thabane, Foster, Griffith, Raina, Santaguida, Papaioannou), McMaster Institute for Research on Aging (Raina), Schools of Rehabilitation Science (Richardson) and of Nursing (Valaitis, Ploeg), McMaster University; Hamilton Health Sciences (Price), Hamilton, Ont.; Leslie Dan Faculty of Pharmacy (Dolovich); University of Toronto; Institute of Health Policy, Management and Evaluation (Kastner), Dalla Lana School of Public Health, University of Toronto; Li Ka Shing Knowledge Institute of St. Michael's Hospital (Straus), Toronto, Ont.

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Classifications MeSH

questionsmedicales.fr › Environnement et santé publique › Santé publique › Accidents › Chutes accidentelles › Combining volunteers and primary care teamwork...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Combining volunteers and primary care teamwork...
questionsmedicales.fr › Activités humaines › Exercice physique › Combining volunteers and primary care teamwork...
questionsmedicales.fr › Comportement et mécanismes comportementaux › Objectifs › Combining volunteers and primary care teamwork...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Prestations des soins de santé › Besoins et demandes de services de santé › Combining volunteers and primary care teamwork...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Services de santé › Services de santé pour personnes âgées › Combining volunteers and primary care teamwork...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Combining volunteers and primary care teamwork...
questionsmedicales.fr › Administration des services de santé › Gestion des soins aux patients › Équipe soignante › Combining volunteers and primary care teamwork...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Enquêtes et questionnaires › Enquêtes sur les soins de santé › Mesures des résultats rapportés par les patients › Combining volunteers and primary care teamwork...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Services de santé › Services de médecine préventive › Combining volunteers and primary care teamwork...
questionsmedicales.fr › Administration des services de santé › Gestion des soins aux patients › Services de santé polyvalents › Soins de santé primaires › Combining volunteers and primary care teamwork...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Mesures épidémiologiques › Démographie › État de santé › Qualité de vie › Combining volunteers and primary care teamwork...
questionsmedicales.fr › Comportement et mécanismes comportementaux › Personnalité › Développement de la personnalité › Concept du soi › Auto-efficacité › Combining volunteers and primary care teamwork...
questionsmedicales.fr › Sciences sociales › Sociologie › Facteurs sociologiques › Environnement social › Soutien social › Combining volunteers and primary care teamwork...
questionsmedicales.fr › Personnes › Bénévoles › Combining volunteers and primary care teamwork...