Development of a Proactive Care Program (U-CARE) to Preserve Physical Functioning of Frail Older People in Primary Care Physical Functioning of Frail Older People in Primary Care

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Development of a Proactive Care Program (U-CARE) to Preserve Physical Functioning of Frail Older People in Primary Care Physical Functioning of Frail Older People in Primary Care

Bleijenberg, Nienke - Personal Name; Dam, Valerie H. ten - Personal Name; Drubbel, Irene - Personal Name; Numans, Mattijs E. - Personal Name; de Wit, Niek J. - Personal Name; Schuurmans, Marieke J. - Personal Name;

Purpose: Care for older patients in primary care is currently reactive, fragmented, and time consuming. An innovative structured and proactive primary care program (U-CARE) has been developed to preserve physical functioning and enhance quality of life of frail older people. This study describes in detail the development process of the U-CARE program to allow its replication. Methods: The framework of the Medical Research Council (MRC) for the development and evaluation of complex interventions was used as a theoretical guide for the design of the U-CARE program. An extended stepwise multimethod procedure was used to develop U-CARE. A team of researchers, general practitioners, registered practice nurses, experts, and an independent panel of older persons was involved in the development process to increase its feasibility in clinical practice. A systematic review of the literature and of relevant guidelines, combined with clinical practice experience and expert opinion, was used for the development of the intervention. Findings: Based on predefined potentially effective guiding components, the U-CARE program comprises three steps: a frailty assessment, a comprehensive geriatric assessment at home followed by a tailor-made care plan, and multiple follow-up visits. Evidence-based care plans were developed for 11 geriatric conditions. The feasibility in clinical practice was tested and approved by experienced registered practice nurses. Conclusions: Using the MRC Framework, a detailed description of the development process of the innovative U-CARE program is provided, which is often missing in reports of complex intervention trials. Based on our feasibility-pilot study, the general practitioners and the registered practice nurses indicated that the U-CARE intervention is feasible in clinical practice. Clinical Relevances: The U-CARE program consists of promising components and has the potential to improve the care of older patients.

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Series Title: Journal of Nursing Scholarship, Volume 45, Number 3 2013
Call Number: (05) 610.5 WIL j
Publisher: Malden : Wiley-Blackwell., 2013
Collation: Hlm. 230-237
Language: English
ISBN/ISSN: 1527-6546
Classification: (05) 610.5 WIL j
Content Type: -
Media Type: -
Carrier Type: -
Edition: Volume 45, Number 3
Subject(s): Frailty
comprehensive geriatric assessment
older people
primary care
nurse
Specific Detail Info: -
Statement of Responsibility: -

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