PT  - JOURNAL ARTICLE
AU  - Lisa Dolovich
AU  - Doug Oliver
AU  - Larkin Lamarche
AU  - Lehana Thabane
AU  - Ruta Valaitis
AU  - Gina Agarwal
AU  - Tracey Carr
AU  - Gary Foster
AU  - Lauren Griffith
AU  - Dena Javadi
AU  - Monika Kastner
AU  - Dee Mangin
AU  - Alexandra Papaioannou
AU  - Jenny Ploeg
AU  - Parminder Raina
AU  - Julie Richardson
AU  - Cathy Risdon
AU  - Pasqualina Santaguida
AU  - Sharon Straus
AU  - David Price
TI  - Combining volunteers and primary care teamwork to support health goals and needs of older adults: a pragmatic randomized controlled trial
AID  - 10.1503/cmaj.181173
DP  - 2019 May 06
TA  - Canadian Medical Association Journal
PG  - E491--E500
VI  - 191
IP  - 18
4099  - http://www.cmaj.ca/content/191/18/E491.short
4100  - http://www.cmaj.ca/content/191/18/E491.full
SO  - CMAJ2019 May 06; 191
AB  - BACKGROUND: The Health TAPESTRY (Health Teams Advancing Patient Experience: STRengthening QualitY) intervention was designed to improve primary care teamwork and promote optimal aging. We evaluated the effectiveness of Health TAPESTRY in attaining goals of older adults (e.g., physical activity, productivity, social connection, medical status) and other outcomes.METHODS: We conducted a pragmatic randomized controlled trial between January and October 2015 in a primary care practice in Hamilton, Ontario. Older adults were randomized (1:1) to Health TAPESTRY (n = 158) or control (n = 154). Trained community volunteers gathered information on people’s goals, needs and risks in their homes, using electronic forms. Interprofessional primary care teams reviewed summaries and addressed issues. Participants reported goal attainment (primary outcome), self-efficacy, quality of life, optimal aging, social support, empowerment, physical activity, falls, and access to and comprehensiveness of the health system. We determined use of health care resources through chart audit.RESULTS: There were no differences between groups in goal attainment or many other patient-reported outcome and experience assessments at 6 months. More primary care visits took place in the intervention versus control group over 6 months (mean ± standard deviation [SD] 4.93 ± 3.86 v. 3.50 ± 3.53; difference of 1.52 [95% confidence interval (CI) 0.84 to 2.19]). The odds of having 1 or more hospital admission were lower for the intervention group (odds ratio [OR] 0.44 [95% CI 0.20 to 0.95]).INTERPRETATION: Health TAPESTRY did not improve the primary outcome of goal attainment but showed signals of shifting care from reactive to active preventive care. Further evaluation will help in understanding effective components, costs and consequences of the intervention. Trial registration: ClinicalTrials.gov, no. NCT02283723See related article at www.cmaj.ca/lookup/doi/10.1503/cmaj.190406