Effects of an updated preventive home visit program based on a systematic structured assessment of care needs for ambulatory frail older adults in Japan: A randomized controlled trial

Abstract

Background: The aim of this randomized controlled trial was to determine the effects on functional parameters of an updated preventive home visit program for frail older adults in the Japanese Long-term Care Insurance (LTCI) system. Methods: The program included home visits by nurses or care managers every 3 months for 24 months, with a systematic assessment of care needs to prevent functional decline. Eligible participants (N = 360) were randomly assigned to the visit (VG: n = 179) or control group (CG: n = 181). Functional parameters were gathered via mail questionnaires at baseline and at 12-and 24-month follow-ups. Care-need levels in the LTCI were obtained at 12-, 24-, and 36-month follow-ups and the utilization of the LTCI service through 36 months. Results: Participants in VG were significantly more likely to maintain their activities of daily living (ADL) functioning (p = .0113) and less likely to increase care-needs level, compared with CG participants, over 24 months. A generalized linear model showed that the estimate of the effect on increase in care-needs level (ie, functional decline) was ?0.53 (p = .042) over 36 months. Conclusions: These results suggest that the updated preventive home visit program could be effective for the prevention of ADL and careneeds deterioration, and these effects could continue up to 1 year after program completion.