Learning from a multidisciplinary randomized controlled intervention in retirement village residents

Area of Science:

• Gerontology
• Geriatric Medicine
• Healthcare Management

Background:

• Retirement villages (RVs) are increasingly popular housing for older adults with significant health needs.
• The health needs of RV residents may fall between community-dwelling older adults and those in long-term residential care (LTC).
• Previous research indicated Gerontology Nurse Specialist (GNS)-facilitated multidisciplinary team (MDT) interventions may reduce hospitalizations from LTC.

Purpose of the Study:

• To test if a GNS-facilitated MDT intervention could reduce hospitalizations in RV residents.
• To evaluate the intervention's impact on acute hospitalizations, LTC admissions, and mortality.
• To assess the effectiveness of integrated care models in RV settings.

Main Methods:

• An open-label randomized controlled trial involving 412 older residents from 33 RVs.
• Participants were randomized (1:1) to either an MDT intervention or usual care.
• The MDT intervention included a geriatrician, nurse practitioner, and clinical pharmacist.

Main Results:

• No significant difference was found in the hazard of acute hospitalization between the MDT intervention and usual care groups (HR=1.01).
• The incidence rate of acute hospitalizations was similar between groups (IRR=0.81).
• No differences were observed in the proportion of residents transitioning to LTC or in mortality rates.

Conclusions:

• The GNS-facilitated MDT intervention did not reduce hospitalizations in RV residents.
• Further studies are required to explore other patient-centered interventions.
• The importance of adequate primary care integration in RV settings needs further investigation.