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A Negative Trial of Inpatient Geriatric Consultation Lessons Learned and Recommendations for Future Research

Carol H. Winograd, MD; Meghan B. Gerety, MD; Nancy A. Lai
Arch Intern Med. 1993;153(17):2017-2023. doi:10.1001/archinte.1993.00410170101010.
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Purpose:  To determine the effectiveness of inpatient interdisciplinary geriatric consultation provided during hospitalization to frail, elderly subjects.

Subjects and Site:  Admission cohort of 197 men admitted from 1985 through 1989, aged 65 years or more, meeting proxy criteria for frailty, living within follow-up area, without terminal illness, and without prolonged nursing home residence.

Methods and Measures:  Randomized controlled trial of inpatient geriatric consultation at a tertiary care Veterans Affairs hospital. Differences were determined between groups in the Physical Self-Maintenance Scale, Instrumental Activities of Daily Living, Mini-Mental State Examination, Morale Scale, and nursing home and health care utilization.

Results:  No differences were seen between groups in any measure after the intervention or during 1 year of followup. Intervention implementation may have been incomplete due to compliance and resource availability.

Conclusions:  This trial is not definitive in determining whether geriatric consultation is effective or ineffective. Lessons learned from this research indicate that future studies should target frail subjects, include intervention-specific measures, and be conducted with direct control of comprehensive resources.(Arch Intern Med. 1993;153:2017-2023)


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