Samenvatting

Background: To improve the effectiveness of community-based care programs, especially those
targeting the oldest-old population (80+), data are needed that elucidate those factors associated
with a successful response to the intervention. Two comparable nurse-led care programs have
been evaluated in two large randomized controlled trials (RCTs), one in Switzerland and one in
the Netherlands.
Aims: To identify common patient characteristics that are related to a successful response to
proactive nurse-led care, we explored if and to what extent, identical factors were present in
both study populations.
Methods: A secondary data analysis using trial data from the intervention group of both RCTs
was conducted. The study sample consisted 461 older adults, 230 from the U-PROFIT trial (the
Netherlands) and 231 from the HPC trial (Switzerland). The mean age of the total sample was 85.1
years (SD 3.7). The UPROFIT intervention, delivered by registered nurses, included a frailty assessment
and a comprehensive geriatric assessment (CGA) at home followed by an individualized
evidence-based care plan, care coordination, and follow-up. The HCP intervention was delivered
by advanced practice nurses consisting of four home visits and three phone calls, and was guided
by the principles of health promotion, empowerment, partnership, and family-centeredness. A
successful response was defined as “stable” or “no decline” in daily functioning at follow-up.
Daily functioning was measured with 13 items of activities of daily living and instrumental activities
of daily living. Multivariate logistic regression models were applied to calculate the association
between individual characteristics and a successful response.