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@ARTICLE{Boekholt:276486,
author = {Boekholt, Melanie and Nikelski, Angela and
Schumacher-Schönert, Fanny and Kracht, Friederike and
Vollmar, Horst Christian and Hoffmann, Wolfgang and Kreisel,
Stefan Henner and Thyrian, Jochen Rene},
title = {{S}upporting older people with cognitive impairment during
and after hospital stays with intersectoral care management
(intersec-{CM})-results of a randomised clinical trial.},
journal = {Age $\&$ ageing},
volume = {54},
number = {2},
issn = {0002-0729},
address = {Oxford},
publisher = {Oxford Univ. Press},
reportid = {DZNE-2025-00303},
pages = {afaf011},
year = {2025},
abstract = {The transition from hospital to primary care is a risk
factor for negative health outcomes in people with cognitive
impairment.To test the effectiveness of intersectoral care
management during the transition from hospital to primary
care on repeated admission to hospital, functionality and
institutionalisation in people with cognitive
impairment.Longitudinal multisite randomised controlled
trial with two arms (care as usual and intersectoral care
management) and two follow-ups 3 and 12 months after
discharge.Three hospitals in two different primary care
regions in Germany.n = 401 people with cognitive impairment:
community-dwelling, age 70+. Randomised into control (n =
192) or intervention (n = 209).Primary outcomes for the
study after 3 months: admission to hospital, physical and
instrumental functionality. Primary outcome after 12 months:
institutionalisation, physical and instrumental
functionality. Secondary outcomes: health-related quality of
life, depressive symptoms, cognitive status and frailty.
Statistical analyses include descriptive analyses as well as
univariate and multivariate regression models for all
outcomes.There was no statistically significant effect of
the intervention on hospital admission and activities of
daily living after 3 months, as well as on
institutionalisation and activities of daily living after 12
months. There were significantly fewer participants in the
intervention group readmitted to the hospital 12 months
after discharge.Analyses show a significant effect on
health-related quality of life 3 months and 12 months after
discharge. Depressive symptoms were significantly less
likely in the intervention group 3 months after discharge.
No effects on cognition or frailty.Intersectoral care
management supports people with cognitive impairment during
discharge and transition. Even though we were not able to
show an impact of the intervention on the chosen primary
outcomes everyday functionality and institutionalisation,
the effects on health-related quality of life, hospital
admission rate and mental health are solid indicators for an
improved individual situation.ClinicalTrials.gov,
NCT03359408;
https://clinicaltrials.gov/ct2/show/NCT03359408.},
keywords = {Humans / Male / Female / Aged / Cognitive Dysfunction:
therapy / Cognitive Dysfunction: psychology / Quality of
Life / Aged, 80 and over / Germany / Activities of Daily
Living / Patient Discharge / Primary Health Care /
Institutionalization / Longitudinal Studies / Cognition /
Time Factors / Patient Readmission / Frailty: therapy /
Frailty: diagnosis / Frailty: psychology / Germany (Other) /
cognitive impairment (Other) / dementia care management
(Other) / hospital discharge (Other) / older people (Other)
/ randomised controlled trial (Other)},
cin = {AG Thyrian / AG Hoffmann},
ddc = {610},
cid = {I:(DE-2719)1510800 / I:(DE-2719)1510600},
pnm = {353 - Clinical and Health Care Research (POF4-353)},
pid = {G:(DE-HGF)POF4-353},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:39912589},
doi = {10.1093/ageing/afaf011},
url = {https://pub.dzne.de/record/276486},
}