Effects of a Preventive Home Visit Program in Ambulatory Frail Older People: A Randomized Controlled Trial

302 OVER previous decades, preventive home visit programs of various types to prevent functional decline among community dwelling older people have been developed. Moreover, some countries have already adopted preventive home visits as a national health policy (1–3). Some systematic reviews and meta-analyses suggest that preventive home visit programs do not have clear effects on mortality (4,5), physical and psychosocial function (4), and health status in community-dwelling elderly people. The individual trials in those systematic reviews or meta-analysis were heterogeneous. However, other meta-analyses investigating 17 randomized controlled trials (6) and 21 trials (7) concluded that preventive home visits are able to reduce disability burden among older people, if home visits program include multidimensional geriatric assessment. Other debate in the literature concerns the ideal target group for preventive home visits. Some studies indicate that general older populations can benefit from preventive home visits in terms of a reduced risk of not living at home or nursing home admission, while frail elders who had severe disability did not benefit as much (8). However, definitions of frailty differ among trials in the meta-analyses (8). Other studies (9,10) show clinically important benefits accruing to elders in the early stage of the frailty such as ambulatory frail elders. Effects of a Preventive Home Visit Program in Ambulatory Frail Older People: A Randomized Controlled Trial