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Cluster randomised trial of a complex interprofessional intervention (interprof ACT) to reduce hospital admission of nursing home residents

  • Background: Some hospital admissions of nursing home residents (NHRs) might be attributed to inadequate interprofessional collaboration. To improve general practitioner–nurse collaboration in nursing homes (NHs), we developed an intervention package (interprof ACT) in a previous study. Objective: To assess the impact of interprof ACT on the proportion of hospitalisation and other clinical parameters within 12 months from randomisation among NHRs. Methods: Multicentre, cluster randomised controlled trial in 34 German NHs. NHRs of the control group received usual care, whereas NHRs in the intervention group received interprof ACT. Eligible NHs had at least 40 long-term care residents. NHs were randomised 1:1 pairwise. Blinded assessors collected primary outcome data. Results: Seventeen NHs (320 NHRs) were assigned to interprof ACT and 17 NHs (323 NHRs) to usual care. In the intervention group, 136 (42.5%) NHRs were hospitalised at least once within 12 months from randomisation and 151 (46.7%) in the control group (odds ratio (OR): 0.82, 95% confidence interval (CI): [0.55; 1.22], P = 0.33). No differences were found for the average number of hospitalisations: 0.8 hospitalisations per NHR (rate ratio (RR) 0.90, 95% CI: [0.66, 1.25], P = 0.54). Average length of stay was 5.7 days for NHRs in the intervention group and 6.5 days in the control group (RR: 0.70, 95% CI: [0.45, 1.11], P = 0.13). Falls were the most common adverse event, but none was related to the study intervention. Conclusions: The implementation of interprof ACT did not show a statistically significant and clinically relevant effect on hospital admission of NHRs.

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Author:Ana Mazur, Britta TetzlaffORCiD, Tina Mallon, Berit Hesjedal-Streller, Vivien Wei, Martin Scherer, Sascha Köpke, Katrin Balzer, Linda Steyer, Tim FriedeORCiD, Sebastian Pfeiffer, Eva Hummers, Christiane Müller
URN:urn:nbn:de:bsz:960-opus4-37419
DOI:https://doi.org/10.25968/opus-3741
DOI original:https://doi.org/10.1093/ageing/afad022
ISSN:0002-0729
Parent Title (English):Age and Ageing
Publisher:Oxford University Press
Document Type:Article
Language:English
Year of Completion:2023
Publishing Institution:Hochschule Hannover
Release Date:2025/12/17
Tag:cluster randomised controlled trial; interprofessional relation; nursing home; older people; patient-centred care; physician–nurse relation
GND Keyword:KrankenhausGND; EinweisungGND; AltenpflegeheimGND; KooperationGND; AltenpflegerGND; AltenpflegerinGND; HausarztGND; HausärztinGND
Volume:52
Issue:3
Article Number:afad022
Page Number:10
Institutes:Fakultät V - Diakonie, Gesundheit und Soziales
DDC classes:610 Medizin, Gesundheit
Licence (German):License LogoCreative Commons - CC BY-NC-ND - Namensnennung - Nicht kommerziell - Keine Bearbeitungen 4.0 International