Effects of preventive home visits on health-related quality-of-life and mortality in home-dwelling older adults

Scand J Prim Health Care. 2019 Mar;37(1):90-97. doi: 10.1080/02813432.2019.1569372. Epub 2019 Feb 27.

Abstract

Objective: We explored the effectiveness of preventive home visits on the health-related quality-of-life (HRQoL) and mortality among independently community-dwelling older adults.

Design: A randomised controlled trial.

Subjects: Independently home-dwelling older adults 75 years and older, consisting of 211 in the intervention and 211 in the control group.

Setting: Hyvinkää town municipality, Finland.

Main outcome measures: We used the change in HRQoL measured by the 15D scale as our primary outcome. Mortality at two years was retrieved from central registers.

Results: At the one-year time point, the HRQoL according to the 15D scores deteriorated in the control group, whereas we found no change in the intervention group. The difference between the 15D score changes between the groups was -0.015 (95% CI -0.029 to -0.0016; p = 0.028, adjusted for age, sex, and baseline value). At the two-year time point as the visits ended, that difference diminished. There was no difference in mortality between the groups during the 24-month follow-up.

Conclusion: Preventive home visits implemented by a multidisciplinary team with CGA appear to help slow down the decline in HRQoL among older adults, although the effect diminishes when the visits end. Key points We are exploring preventive home visits as means to support the health-related quality-of-life (HRQoL) of home-dwelling older adults Multiprofessional preventive home visits in this intervention study helped to maintain the HRQoL when measured using 15D The effects on HRQoL diminished when the intervention ended, so could further benefits be attained with a longer intervention?The clinical trial registration number: ACTRN12616001411437.

Keywords: Prevention; comprehensive geriatric assessment; health-related quality-of-life; older adults; preventive home visit.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Activities of Daily Living*
  • Aged
  • Aged, 80 and over
  • Female
  • Finland / epidemiology
  • Geriatric Assessment*
  • Home Care Services
  • House Calls*
  • Humans
  • Independent Living*
  • Male
  • Mortality
  • Preventive Health Services*
  • Quality of Life*

Grant support

This study was funded by a university-level health research grant from HYYKS's area of responsibility (ERVA) (HYKS:n erityisvastuualue) [four grants for the research group between 2013 and 2016] and supported by the Medical Officer Uulo Arhio Foundation [grant for corresponding author Heini Liimatta in 2016], the Finnish Medical Foundation (Suomen Lääketieteen Säätiö) [grant for corresponding author Heini Liimatta in 2016 and 2018], the Paulo Foundation [grant for corresponding author Heini Liimatta in 2018], and the Päivikki and Sakari Sohlberg Foundation [grant for corresponding author Heini Liimatta in 2018].