Growing old at home – Evaluation of preventive home visits to reduce the number of falls and to preserve the quality of life

Abstract

Einleitung/Hintergrund: Preventive home visits offer the possibility to preserve self-supply and self-care skills, to enhance the family care, to connect to formal care services, and thus to avoid or delay institutionalization. The aim of this study was to evaluate the effectiveness of preventive home visits to reduce the number of falls and to preserve health-related quality of life. Daten und Methoden: The study was designed as a prospective multi-center randomized controlled trial. Participants were randomized to an intervention group (n=150) and a control group (n=155). The control group received usual care. The intervention group received three additional home visits: geriatric assessment, consultation, and booster session. 18 months after the 1st home visit, a follow-up assessment was conducted in both groups. At baseline and follow-up, the health-related quality of life was measured with the EQ-5D and the visual analog scale EQ-VAS. The number of falls was assessed with the question: „How often have you fallen in the last 12 months?“. Ergebnisse: The number of falls significantly increased from baseline to follow-up in the control group and significantly decreased in the intervention group. With regard to the results on EQ-5D sum score, no time-, group- or time x group interaction effects on health-related quality of life were found. Regarding results on EQ-VAS, however, the health-related quality of life significantly decreased from baseline to follow-up in the control group and remained stable in the intervention group. Diskussion/Schlussfolgerungen: Results of the evaluation indicate that preventive home visits can be effective to reduce the number of falls and to preservate the health-related quality of life (EQ-VAS). However, preventive home visits are complex and individualized interventions. Further research is required to identify the factors of preventive home visits that specifically affect the changes in complex outcome measures such as quality of life.