Effect of home-based comprehensive geriatric assessment on hospital days in multimorbid older adults: a randomized...

To determine whether Comprehensive Geriatric Assessment (CGA)-based healthcare, delivered by a mobile team over 24 months in patients' homes reduces hospital care or improves quality of life, physical performance, frailty, activities of daily living (ADL), or cognition and whether it reduces mortality or number of hospital admissions.

Patients ≥ 75 years of age, with ≥ 3 visits to the Emergency Department in the last 18 months, with ≥ 3 diagnosed diseases, living in their own home and within the catchment area of the local hospital were invited to the study. Enrolled patients were randomized to either the intervention group, which received CGA-based healthcare by a geriatric mobile team in addition to usual healthcare, or a control group which received usual healthcare only.

450 participants were randomised equally into the intervention and the control groups. The participant's mean age was 83 years (SD = 5.5) and 245 were female (54%). The mean number of days spent in hospital did not differ between the intervention and control groups after 24 months (16.2 and 17.6 days; P = 0.14) follow-up. There were also no differences in mortality, quality of life, frailty levels, or other health-related outcome measures.

This study did not show any clinically relevant effect of home CGA-based healthcare delivering over 24 months on the outcomes measured. We question the quality of the intervention and speculate that lack of continuity and scarce team building could have contributed to the results.

The trial was registered at ClinicalTrials.gov in year 2016 with ID: NCT02923843.