Effects and feasibility of an Integrative Medicine program for geriatric patients–a cluster-randomized pilot study

Figures & data

Figure 1 Trial flow chart.

Table 1 Sociodemographic data and characteristics of patients at baseline in both study groups

	Integrative Medicine group (n = 29)	Usual care group (n = 29)
Demographics
Age, years (± SD)	82.7 (±8.6)	76.0 (±12.8)
Female, n (%)	25 (86.2)	14 (48.2)
Legal guardian, n (%)	21 (72.4)	27 (93.1)
Disease history
Maximum level of care, n (%)	7 (24.1)	3 (10.3)
Number of ICD diagnoses, mean (± SD)	9.9 (±2.9)	9.6 (±2.9)
Cognitive impairment, n (%)	16 (55.1)	14 (48.2)
Apoplectic insult history, n (%)	2 (6.8)	6 (20.6)
Number of drugs taken, mean (± SD)	7.0 (±3.4)	9.6 (±2.9)

Table 2 Outcome measures at baseline and after 3, 6, and 12 months (mean, 95% confidence intervals, Cohen’s d/effect sizes, adjusted for baseline differences)

Outcome parameter	Results at 3 months			Results at 6 months			Results at 12 months
	IM mean (95% CI)	UC mean (95% CI)	Effect size Cohen’s d (95% CI)	IM mean (95% CI)	UC mean (95% CI)	Effect size Cohen’s d (95% CI)	IM mean (95% CI)	UC mean (95% CI)	Effect size Cohen’s d (95% CI)
Activities of daily living
Barthel index	46.6	42.4	0.14	45.0	42.4	0.09	50.2	41.4	0.30
	(37.3; 55.9)	(37.1; 47.8)	(−0.08; 0.37)	(35.3; 54.7)	(36.8; 47.9)	(−0.15; 0.34)	(39.6; 60.8)	(35.3; 47.4)	(0.03; 0.57)
AMPS motor skills	−0.3	−0.1	−0.12	−0.4	−0.1	−0.18	0.1	−0.1	0.12
	(−0.7; 0.1)	(−0.1;−0.1)	(−0.36; 0.11)	(−0.9; 0.1)	(−0.1;−0.1)	(−0.49; 0.13)	(−0.3; 0.6)	(−0.1;−0.1)	(−0.16; 0.41)
AMPS process skills	−0.6	−0.6	0.04	−0.7	−0.6	−0.04	−0.7	−0.6	−0.06
	(−1.0;−0.2)	(−0.8; −0.5)	(−0.21; 0.29)	(−1.1;−0.2)	(−0.8; −0.5)	(−0.37; 0.30)	(−1.2;−0.2)	(−0.8; −0.5)	(−0.49; 0.40)
Cognition
Mini-mental state examination	1 1.7	13.4	−0.19	13.2	13.8	−0.06	15.4	13.9	0.15
	(9.4; 13.9)	(12.1; 14.8)	(−0.39; 0.01)	(11.2; 15.3)	(12.5; 15.0)	(−0.26; 0.14)	(12.5; 18.2)	(12.1; 15.7)	(−0.13; 0.43)
Quality of life
Profile of Wellbeing	14.3	13.4	0.14	12.5	10.4	0.33	15.5	13.2	0.36
	(10.7; 17.9)	(10.5; 16.2)	(−0.16; 0.45)	(7.6; 17.5)	(7.0; 13.8)	(−0.23; 0.89)	(11.0; 20.0)	(9.9; 16.6)	(−0.12; 0.84)
Qualidem (total sum score)	56.6	54.1	0.14	51.6	50.1	0.08	56.0	49.0	0.39
	(41.5; 71.8)	(42.7; 65.6)	(−0.39; 0.67)	(36.8; 66.3)	(39.9; 60.3)	(−0.50; 0.67)	(39.1; 72.8)	(36.1; 62.0)	(−0.20; 0.98)
Care relationship	9.8	8.8	0.27	8.2	8.2	−0.02	6.9	6.3	0.16
	(6.4; 13.2)	(6.2; 11.4)	(−0.33; 0.86)	(4.2; 12.2)	(5.4; 11.0)	(−0.80; 0.77)	(2.5; 11.3)	(2.7; 10.0)	(−0.54; 0.87)
Feeling at home	5.3	4.9	0.13	4.1	4.7	−0.18	3.2	3.6	−0.11
	(2.8; 7.8)	(3.3; 6.4)	(−0.48; 0.74)	(1.7; 6.5)	(3.2; 6.2)	(−0.80; 0.44)	(1.3; 5.1)	(2.5; 4.7)	(−0.60; 0.37)
Social isolation	3.5	3.3	0.07	3.6	3.3	0.15	3.9	3.5	0.15
	(1.8; 5.2)	(2.3;4.3)	(−0.57; 0.70)	(2.1; 5.2)	(2.2; 4.3)	(−0.40; 0.71)	(2.6; 5.2)	(2.5; 4.5)	(−0.34; 0.64)
Positive self-image	4.0	3.2	0.30	3.3	2.5	0.28	3.4	2.9	0.23
	(2.0;5.9)	(2.1;4.3)	(−0.29; 0.89)	(1.7; 4.8)	(1.5; 3.6)	(−0.22; 0.79)	(2.0; 4.9)	(1.9; 3.8)	(−0.25; 0.71)
Restless tense behavior	1.3	2.3	−0.51	2.6	2.7	−0.05	2.2	1.7	0.24
	(0.2; 2.4)	(1.6; 3.0)	(−0.96; −0.06)	(1.3; 3.9)	(1.8; 3.6)	(−0.61; 0.52)	(0.8; 3.6)	(0.8; 2.6)	(−0.41; 0.90)
Having something to do	2.6	2.2	0.18	2.4	2.2	0.08	2.7	2.0	0.35
	(1.7; 3.5)	(1.8; 2.7)	(−0.18; 0.54)	(1.3; 3.4)	(1.7; 2.7)	(−0.38; 0.54)	(1.6; 3.8)	(1.4; 2.5)	(−0.15; 0.86)
Negative affect	3.0	2.8	0.08	3.6	3.2	0.17	4.9	4.2	0.33
	(1.6; 4.4)	(1.9; 3.8)	(−0.30; 0.46)	(2.1; 5.0)	(2.2; 4.1)	(−0.26; 0.60)	(3.3; 6.6)	(3.1; 5.3)	(−0.16; 0.82)
Positive affect	10.1	10.8	0.03	9.9	9.0	0.21	10.3	8.7	0.37
	(8.3; 13.4)	(8.7; 12.8)	(−0.31; 0.36)	(6.1; 13.7)	(6.1; 11.9)	(−0.38; 0.80)	(5.9; 14.6)	(5.4; 12.0)	(−0.31; 1.05)
Social relation	8.0	7.4	0.17	8.4	8.0	0.10	8.3	6.4	0.49
	(5.4; 10.7)	(5.4; 9.4)	(−0.22; 0.57)	(5.5; 11.3)	(6.2; 9.8)	(−0.48; 0.68)	(5.1; 11.4)	(4.3; 8.6)	(−0.07; 1.05)
Multidimensional NOSGER
Depressed mood	4.8	5.4	0.17	5.2	6.3	0.31	4.1	5.4	0.40
	(2.7; 7.0)	(3.5; 7.3)	(−0.22; 0.55)	(3.2; 7.3)	(4.5; 8.0)	(−0.09; 0.70)	(1.9; 6.2)	(3.8; 7.1)	(−0.08; 0.89)
Impaired activities of daily living	9.1	10.6	0.31	9.7	11.6	0.41	8.3	10.8	0.53
	(6.0; 12.2)	(8.1; 13.1)	(−0.25; 0.88)	(7.0; 12.3)	(8.9; 14.3)	(0.02; 0.80)	(5.7; 10.9)	(8.3; 13.4)	(0.09; 0.97)
Impaired memory	11.7	12.5	0.18	9.6	11.4	0.40	11.3	11.6	0.08
	(8.1; 15.3)	(9.0; 16.0)	(−0.33; 0.69)	(5.9; 13.3)	(8.2; 14.6)	(−0.08; 0.88)	(6.7; 15.9)	(7.9; 15.4)	(−0.51 ; 0.66)
Impaired social behavior	8.9	10.1	0.21	8.4	9.8	0.25	8.8	11.4	0.47
	(5.5; 12.4)	(7.2; 13.0)	(−0.25; 0.67)	(4.9; 11.9)	(6.8; 12.7)	(−0.24; 0.74)	(5.2; 12.5)	(8.6; 14.3)	(−0.08; 1.03)
Disturbing behavior	5.3	6.5	0.36	4.7	5.3	0.20	3.8	3.9	0.03
	(2.2; 8.5)	(4.6; 8.4)	(−0.36; 1.07)	(1.7; 7.6)	(3.4; 7.3)	(−0.41; 0.82)	(1.1; 6.6)	(2.1; 5.7)	(−0.59; 0.64)
Impaired instrumental activities of daily living	14.7	14.5	−0.03	13.7	14.1	0.09	18.3	19.1	0.18
	(11.0; 18.4)	(11.0; 18.0)	(−0.43; 0.37)	(10.1; 17.3)	(10.6; 17.5)	(−0.30; 0.49)	(14.2; 22.4)	(15.4; 22.8)	(−0.36; 0.72)
Risk of falls
Tinetti score	11.1	11.0	0.01	10.4	11.0	−0.07	11.0	10.7	0.04
	(8.7; 13.5)	(9.7; 12.3)	(−0.21; 0.23)	(7.7; 13.1)	(9.5; 12.4)	(−0.35; 0.20)	(7.8; 14.2)	(9.0; 12.4)	(−0.29; 0.37)

Abbreviations: AMPS, assessment of motor and process skills; CI, confidence interval; IM, Integrative Medicine; NOSGER, nurses observation scale for geriatric patients; UC, usual care.