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Open Access Study protocol

The PRO-AGE study: an international randomised controlled study of health risk appraisal for older persons based in general practice

Andreas E Stuck12*, Kalpa Kharicha3, Ulrike Dapp4, Jennifer Anders4, Wolfgang von Renteln-Kruse4, Hans Peter Meier-Baumgartner4, Steve Iliffe3, Danielle Harari6, Martin D Bachmann1, Matthias Egger5, Gerhard Gillmann5, John C Beck7 and Cameron G Swift8

Author Affiliations

1 University Department of Geriatrics, Spital Bern-Ziegler, Morillonstrasse 75-91, CH-3001 Bern, Switzerland

2 Division of Geriatrics, Department of General Internal Medicine, Insel University Hospital, CH-3010 Bern, Switzerland

3 Department of Primary Care and Population Sciences, University College London, Hampstead Campus, Rowland Hill Street, London NW3 2PF, UK

4 Albertinen-Haus Geriatrics Centre, University of Hamburg, Sellhopsweg 18-22, D-22459 Hamburg, Germany

5 Department of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, CH-3012 Bern, Switzerland

6 Department of Ageing and Health, Guys and St Thomas' NHS Foundation Trust, 9th Floor North Wing, St Thomas' Hospital, Lambeth Palace Road, London SE1 7EH, UK

7 School of Medicine, University of California School of Medicine, 10833 Le Conte Ave. 32-144, Los Angeles CA-90024-1687, USA

8 Department of Health Care of the Elderly, Kings College London, Clinical Age Research Unit, King's College Hospital, Bessemer Road, London SE5 9PJ, UK

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BMC Medical Research Methodology 2007, 7:2  doi:10.1186/1471-2288-7-2

Published: 11 January 2007

Abstract

Background

This paper describes the study protocol, the recruitment, and base-line data for evaluating the success of randomisation of the PRO-AGE (PRevention in Older people – Assessment in GEneralists' practices) project.

Methods/Design

A group of general practitioners (GPs) in London (U.K.), Hamburg (Germany) and Solothurn (Switzerland) were trained in risk identification, health promotion, and prevention in older people. Their non-disabled older patients were invited to participate in a randomised controlled study. Participants allocated to the intervention group were offered the Health Risk Appraisal for Older Persons (HRA-O) instrument with a site-specific method for reinforcement (London: physician reminders in electronic medical record; Hamburg: one group session or two preventive home visits; Solothurn: six-monthly preventive home visits over a two-year period). Participants allocated to the control group received usual care. At each site, an additional group of GPs did not receive the training, and their eligible patients were invited to participate in a concurrent comparison group. Primary outcomes are self-reported health behaviour and preventative care use at one-year follow-up. In Solothurn, an additional follow-up was conducted at two years. The number of older persons agreeing to participate (% of eligible persons) in the randomised controlled study was 2503 (66.0%) in London, 2580 (53.6%) in Hamburg, and 2284 (67.5%) in Solothurn. Base-line findings confirm that randomisation of participants was successful, with comparable characteristics between intervention and control groups. The number of persons (% of eligible) enrolled in the concurrent comparison group was 636 (48.8%) in London, 746 (35.7%) in Hamburg, and 1171 (63.0%) in Solothurn.

Discussion

PRO-AGE is the first large-scale randomised controlled trial of health risk appraisal for older people in Europe. Its results will inform about the effects of implementing HRA-O with different methods of reinforcement.