NCT03180606

Enhanced Primary Care for Elderly

Completed Last updated 5 June 2020

What this trial tests

trial testing Multi-disciplinary and personalized primary care in Frail Elderly Syndrome in 1,304 participants. Completed in 31 December 2019.

Timeline

27 September 2017

Primary endpoint
31 December 2019

31 December 2019

Quick facts

Lead sponsor	Region Östergötland
Status	Completed
Study type	OBSERVATIONAL
Enrollment	1,304
Start date	27 September 2017
Primary completion	31 December 2019
Estimated completion	31 December 2019
Sites	2 locations across Sweden

Drugs / interventions tested

• Multi-disciplinary and personalized primary care

Conditions studied

• Frail Elderly Syndrome — all drugs for Frail Elderly Syndrome →

Sponsor

Region Östergötland

Who can join

Adults 75 to 110, any sex, with Frail Elderly Syndrome. Patients with the condition only — healthy volunteers not accepted.

Sponsor's own description

The present health care situation for the elderly in many countries is insufficient and not designed according to the health care needs of the aged population. In a pragmatic multicenter primary care setting (n= 1600), the investigators use an evidence based prediction model to find elderly (75+) with high risk for complex medical care or hospitalization and apply a differentiated and directed medical and social care to this risk group, in comparison to usual care. The intervention will include all the latest evidence based tools in the care of elderly (multi-professional team, social support, medical care home-visits, telephone support, general practitioner visits, etc). The project has high potential impact on the development of future care of elderly.

In addition to the intervention study, several academic sub-studies focusing on patient's perspective, professional roles, equality, implementation and governance management of health care will be performed.

Publications & conference data

7 peer-reviewed publications reference this trial (live from Europe PMC):

1. Costs and effects of comprehensive geriatric assessment in primary care for older adults with high risk for hospitalisation.
   Nord M, Lyth J, Alwin J, Marcusson J. · · 2021 · cited 48× · PMID 33882862 · DOI 10.1186/s12877-021-02166-1
2. Proactive healthcare for frail elderly persons: study protocol for a prospective controlled primary care intervention in Sweden.
   Marcusson J, Nord M, Johansson MM, Alwin J, et al · · 2019 · cited 22× · PMID 31122995 · DOI 10.1136/bmjopen-2018-027847
3. Reasons for hospitalisation and cumulative mortality in people, 75 years or older, at high risk of hospital admission: a prospective study.
   Lundgren M, Segernäs A, Nord M, Alwin J, et al · · 2024 · cited 9× · PMID 38378482 · DOI 10.1186/s12877-024-04771-2
4. Effects of proactive healthcare on pain, physical and activities of daily living functioning in vulnerable older adults with chronic pain: a pragmatic clinical trial with one- and two-year follow-up.
   Dong HJ, Peolsson A, Johansson MM. · · 2024 · cited 4× · PMID 38446408 · DOI 10.1007/s41999-024-00952-9
5. Association between frailty and pain in older people at high risk of future hospitalization.
   Dong HJ, Yang J, Johansson MM, Peolsson A, et al · · 2025 · cited 3× · PMID 40386744 · DOI 10.3389/fpain.2025.1576691
6. Dizziness in older persons at high risk of future hospitalization: prevalence, differences between those with and without dizziness, and effect of a proactive primary care intervention.
   Kammerlind AS, Peolsson A, Johansson MM. · · 2022 · cited 2× · PMID 35399055 · DOI 10.1186/s12877-022-02910-1
7. Self-rated health as a predictor of mortality and healthcare use in older adults at high risk of hospitalisation: a prospective cohort study in Sweden.
   Hansén K, Lyth J, Segernäs A, Alwin J, et al · · 2025 · cited 1× · PMID 40889980 · DOI 10.1136/bmjopen-2024-091787