Complex interventions in elderly - how do we determine the effect?
Koffeman, A.R.
Nederlands Tijdschrift Voor Geneeskunde 160: D816
2016
ISSN/ISBN: 1876-8784 PMID: 27781968 Document Number: 687919
The care for frail elderly is challenging and requires an individualised approach. To meet the complex care needs of these patients, interventions aimed at improving care often consist of multiple interacting components. Several recent RCTs investigating such complex interventions in a primary care setting were unable to show an effect. In this paper the challenges that arise when examining complex interventions in experimental trials are discussed. Standardisation of the content of the intervention is often not desirable. The context in which the intervention takes place cannot be controlled and is in itself complex. A thorough process evaluation is essential in order to interpret the findings correctly. The relevant outcomes in such trials are often multidimensional and difficult to capture with a quantitative instrument. Such complex interventions, therefore, require a combination of quantitative and qualitative research methods.