Preventive home visits for community-dwelling frail elderly people based on Minimum Data Set-Home Care: Randomized controlled trial

Authors


Yukari Yamada, RN, MHSc, Department of Health Policy and Management, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160–8582, Japan. Email: yamada-y@sc.itc.keio.ac.jp

Abstract

Background:  Although preventive home visits for the elderly are mandatory in Japan, there has been little research into their effectiveness. The present study used the Minimum Data Set-Home Care (MDS-HC) as the basis for assessing community-dwelling frail elderly persons.

Methods:  The present study was a randomized controlled, community-based investigation of 368 elderly people aged 65 years and older who were dependent in the instrumental activities of daily living, but independent in activities of daily living. The participants were randomly assigned to an intervention group (184) or a control group (184). For 18 months, the intervention group received scheduled home visits by public health nurses who had been instructed that the primary objective of these visits was human interaction. The MDS-HC was used to assess the elderly person at each visit. The primary outcome was the EQ-5D score of the EuroQol and secondary outcomes were five items constituting the EQ-5D, self-rated health, and health behaviors. The types of advice given and subject compliance were also analyzed.

Results:  Intervention had no effect on the EQ-5D score, and positive results were limited to some aspects of health behavior. Subgroup analyses showed that the home visits were effective for elderly people who perceived their own health as poor at baseline, and for participants who complied with advice.

Conclusions:  The preventive home visits based on the MDS-HC were effective in selected groups of frail elderly people. Further modification in the use of the MDS-HC and more focused targeting are needed to make the visits more effective.

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