Rapid emergency department intervention for older people reduces risk of functional decline: Results of a multicenter randomized trial.

Determined the effectiveness of a two-stage (screening and nursing assessment) intervention for older patients (65+) in the emergency department (ED) who are at increased risk of functional decline and other adverse outcomes. Participants were patients expected to be released from the ED to the community with a score of 2 or more on the Identification of Seniors At Risk (ISAR) screening tool and their primary family caregivers. 178 were randomized to the intervention, 210 to usual care. The intervention consisted of disclosure of results of the ISAR screen, a brief standardized nursing assessment in the ED, and notification of the primary care physician and home care providers. Outcomes assessed at 4 mo after enrollment included functional decline and depressive symptoms. Caregiver outcomes, also assessed at baseline and 4 mo, included the physical and mental summary scales of the Medical Outcomes Study Short Form-36. The intervention increased the rate of referral to the primary care physician and to home care services. The intervention was associated with a significantly reduced rate of functional decline at 4 months, in both unadjusted and adjusted analyses. There was no intervention effect on patient depressive symptoms, caregiver outcomes, or satisfaction with care. (PsycInfo Database Record (c) 2022 APA, all rights reserved)