Clinical Trial: A Case Finding and Referral System for Older Veterans within Primary Care

This study has been completed.

Sponsored by: Department of Veterans Affairs
Information provided by: Department of Veterans Affairs

Purpose

Underdiagnosis and undertreatment of elderly persons remains a widespread problem. While many innovative geriatric care programs exist within VHA, we still lack a systematic process for identifying at-risk elders from the larger VA population who are likely to benefit from specialized geriatric services. Our goal is to improve care for at-risk older veterans through a comprehensive system of casefinding, assessment, referral and follow-up within the primary care setting. We hypothesize that subjects receiving this intervention will have more complete evaluation and treatment for selected geriatric conditions (i.e., falls, urinary incontinence, functional status impairments, depression, and cognitive deficits), better continuity of care, less decline in functional status, and better general health than subjects receiving usual care. This randomized controlled trial is being performed at the Sepulveda VA Outpatient Clinic. The study sample is composed of community-dwelling veterans aged 65 and older who are not receiving VA geriatric services. Veterans are mailed a health screening survey to identify those at risk for decline based on criteria established in pilot work. At-risk respondents who are in the intervention group receive a structured telephone assessment (casefinding) and referral to appropriate geriatric services, including a geriatric assessment and teaching clinic integrated with primary care, and telephone case management. Subjects in the control group receive usual care. Major outcome measures collected by telephone interview at baseline, 12, 24, and 36 months include functional status, self-rated health, satisfaction, and health care utilization. Medical records are reviewed for evidence of evaluation and treatment of the target conditions.

Condition Treatment or Intervention
Depression
Urinary Incontinence
Geriatrics
 Behavior: Casefinding and Referral System

MedlinePlus related topics:  Depression;   Urinary Incontinence

Study Type: Interventional
Study Design: Treatment, Randomized, Open Label, Active Control, Single Group Assignment

Further Study Details: 

Expected Total Enrollment:  792

Study start: October 1996;  Study completion: September 2001

Eligibility

Ages Eligible for Study:  65 Years and above,  Genders Eligible for Study:  Both

Accepts Healthy Volunteers

Criteria

Subjects have to have a score of 4 or higher in a screening questionnaire and have been sees at clinic in the past 18 months.

Location Information


California
      VA Greater Los Angeles Healthcare System, Sepulveda,  California,  91343,  United States

      VA Greater Los Angeles Healthcare System, Sepulveda,  California,  91311,  United States

      VA Greater Los Angeles Healthcare System, Sepulveda,  California,  91311,  United States

More Information

Publications

Hoyl MT, Alessi CA, Harker JO, Josephson KR, Pietruszka FM, Koelfgen M, Mervis JR, Fitten LJ, Rubenstein LZ. Development and testing of a five-item version of the Geriatric Depression Scale. J Am Geriatr Soc. 1999 Jul;47(7):873-8.

Study ID Numbers:  IIR 95-050
Record last reviewed:  September 2000
Last Updated:  October 13, 2004
Record first received:  March 14, 2001
ClinicalTrials.gov Identifier:  NCT00012740
Health Authority: United States: Federal Government
ClinicalTrials.gov processed this record on 2005-04-08


Source: ClinicalTrials.gov
Cache Date: April 9, 2005