Effects Of Increasing The Involvement Of Community-Dwelling Frail Older Adults In A Proactive Assessment Service: A Pragmatic Trial

Figures & data

Table 1 The Content Of The Sage-atAge And Sage-atAge+ Service

Service Element	Content	Sage-atAge	Sage-atAge+
Start	Invitation by GP.	♦	♦
Triage	Care profile (based upon frailty and case complexity) or frailty level.	♦	♦
Assessment	Multi-domain assessment by a nurse or elderly care physician.	♦	♦
	Using motivational interviewing, setting goals, and filling in a goal card.		♦
	Oral screening by a dental care worker.	♦	♦
	Medication evaluation by a pharmacist.	♦	♦
	Additional: consult from an allied health-care professional.	♦	♦
	Using motivational interviewing, setting goals, and adding these to the goal card.		♦
Actions	Actions carried out by older adult and/or GP based on recommendations sent to the GP …	♦	♦
	… and the goals and corresponding actions are written on the goal card and sent to the GP.		♦

Abbreviation: GP, general practitioner.

Figure 1 Flowchart of study participation.

Notes: ^aInclusion criteria: Groningen Frailty Indicator ≥4 and/or a care profile ≥2 Sage-atAge+ = the Sage-atAge service with the additional aim of increasing the involvement of the older adult through motivational interviewing and goal setting.

Table 2 Baseline Characteristics

		Sage-atAge	Sage-atAge+
		n = 223	n = 230
Age (mean [SD], range)		76.5 (7.2), 65–98	77.2 (6.9), 64–94
Gender	Female	145 (65)	135 (59)
	Male	78 (35)	95 (41)
Marital status	Married	102 (51^a)	131 (60)
	Divorced	20 (10)	14 (6)
	Widowed	70 (35)	65 (30)
	Unmarried	10 (5)	9 (4)
Living situation	Alone	99 (49)	97 (44)
	With others	103 (51)	122 (56)
Educational level^b	Low	67 (33)	73 (33^a)
	Medium	100 (50)	117 (53)
	High	35 (17)	29 (13)
Frailty (mean (SD), range)	Possible range 0–15	4.7 (2.2), 0–11	4.5 (2.2), 0–11
Case complexity (mean (SD), range)	Possible range 0–60	12.7 (5.3), 1–31	12.6 (5.2), 3–35
Care profile^c	1. Feeling vital	28 (13^a)	26 (11^a)
	2. Psychosocial coping difficulties	122 (55)	111 (48)
	3. Physical and mobility needs	56 (25)	74 (32)
	4. Difficulties in multiple domains	17 (8)	19 (8)
Well-being^c, d (mean [SD] range)	Possible range 0–10	8.1 (1.0), 4.6–9.8	8.1 (0.9), 4.8–9.7
Well-being distribution by care profile (mean [SD])	Care profile 1	8.7 (0.56)	8.7 (0.48)
	Care profile 2	8.3 (0.78)	8.4 (0.64)
	Care profile 3	7.7 (1.06)	7.9 (0.84)
	Care profile 4	6.7 (1.1)	6.5 (1.1)
Dependency (mean [SD] range)	Range 0–15	1 (0–3) 0–11	1 (0–2.25) 0–15
Morbidity (mean [SD] range)	Range 0–17	2 (1–3) 0–8	2 (1–3) 0–8
Restrictions in social functioning	Never or rarely	129 (64)	146 (68)
	Sometimes, mostly or continuous	73 (36)	68 (32)
Quality of life	Excellent to very good	54 (27)	53 (25)
	Good	96 (48)	114 (53)
	Reasonable to poor	52 (26^a)	47 (22)
Psychological (mean [SD], range)	Possible range 5–30	11.5 (4.3), 5–29	10.8 (3.9), 5–24
Cognition	No problems	120 (59)	126 (59)
	Any to severe problems	82 (41)	88 (41)
Pain	No pain	46 (23)	43 (20)
	Any to severe pain	156 (77)	171 (80)

Notes: Values are numbers (percentages) unless stated otherwise. ^aSum >100% or <100% by rounding. ^bLow = preprimary school or low vocational training; medium = secondary professional education; high = higher professional education/university. ^cA higher score indicates better performance. ^dMissing data (Sage-atAge, n = 21; Sage-atAge+, n = 16).

Table 3 Linear Regression Models Of The Difference In General Well-Being Between The Two Service Options At Follow-Up

	Unadjusted Model				Adjusted Model^a
	B	95% CI		p	B	95% CI		p
Total population
Sage-atAge vs Sage-atAge+	0.037	−0.188	0.263	0.75	0.029	−0.118	0.177	0.70
Participants who received the service as intended^b
Sage-atAge vs Sage-atAge+	0.193	−0.065	0.452	0.14	0.063	−0.111	0.238	0.48

Notes: General well-being was assessed by the TOPICS-CEP7; 0 = Sage-atAge; 1 = Sage-atAge+. ^aAdjusted for propensity score and TOPICS-CEP7 at baseline. ^bAll Sage-atAge participants and the selection of Sage-atAge+ participants receiving a goal card.

Data Availability

Data are available upon reasonable request to the first author.