A nurse‐led comprehensive geriatric assessment intervention in primary care: A feasibility cluster randomized controlled trial

Abstract

AbstractAimTo determine the feasibility of a nurse‐led, primary care‐based comprehensive geriatric assessment (CGA) intervention.DesignA feasibility cluster randomized controlled trial.MethodsThe trial was conducted in six general practices in the United Kingdom from May 2018 to April 2020. Participants were moderately/severely frail people aged 65 years and older living at home. Clusters were randomly assigned to the intervention arm control arms. A CGA was delivered to the intervention participants, with control participants receiving usual care. Study outcomes related to feasibility of the intervention and of conducting the trial including recruitment and retention. A range of outcome measures of quality of life, function, loneliness, self‐determination, mortality, hospital admission/readmission and number of prescribed medications were evaluated.ResultsAll pre‐specified feasibility criteria relating to recruitment and retention were met with 56 participants recruited in total (30 intervention and 26 control). Retention was high with 94.6% of participants completing 13‐week follow‐up and 87.5% (n = 49) completing 26‐week follow‐up. All outcome measures instruments met feasibility criteria relating to completeness and responsiveness over time. Quality of life was recommended as the primary outcome for a definitive trial with numbers of prescribed medications as a secondary outcome measure.ConclusionIt is feasible to implement and conduct a randomized controlled trial of a nurse‐led, primary care‐based CGA intervention.ImpactThe study provided evidence on the feasibility of a CGA intervention for older people delivered in primary care. It provides information to maximize the success of a definitive trial of the clinical effectiveness of the intervention.Patient or Public ContributionPatient and public representatives were involved in the study design including intervention development and production of participant‐facing documentation. Representatives served on the trial management and steering committees and, as part of this role, interpreted feasibility data. ISRCTN Number: 74345449.