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Szanton SL, Leff B, Li Q, et al. CAPABLE program improves disability in multiple randomized trials. J Am Geriatr Soc. 2021;69(12):3631-3640doi: 10.1111/jgs.17383.
Szanton, S. L., Leff, B., Li, Q., Breysse, J., Spoelstra, S., Kell, J., Purvis, J., Xue, Q. L., Wilson, J., & Gitlin, L. N. (2021). CAPABLE program improves disability in multiple randomized trials. Journal of the American Geriatrics Society, 69(12), 3631-3640. https://doi.org/10.1111/jgs.17383
Szanton, Sarah L, et al. "CAPABLE program improves disability in multiple randomized trials." Journal of the American Geriatrics Society vol. 69,12 (2021): 3631-3640. doi: https://doi.org/10.1111/jgs.17383
Szanton SL, Leff B, Li Q, Breysse J, Spoelstra S, Kell J, Purvis J, Xue QL, Wilson J, Gitlin LN. CAPABLE program improves disability in multiple randomized trials. J Am Geriatr Soc. 2021 Dec;69(12):3631-3640. doi: 10.1111/jgs.17383. Epub 2021 Jul 27. PMID: 34314516.
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J Am Geriatr Soc. 2021 Dec;69(12):3631-3640. doi: 10.1111/jgs.17383. Epub 2021 Jul 27.

CAPABLE program improves disability in multiple randomized trials.

Journal of the American Geriatrics Society

Sarah L Szanton, Bruce Leff, Qiwei Li, Jill Breysse, Sandra Spoelstra, Judith Kell, James Purvis, Qian-Li Xue, Jonathan Wilson, Laura N Gitlin

Affiliations

  1. Johns Hopkins School of Nursing, Baltimore, Maryland, USA.
  2. Johns Hopkins School of Public Health, Baltimore, Maryland, USA.
  3. Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
  4. National Center for Healthy Housing, Columbia, Maryland, USA.
  5. Grand Valley State University, Grand Rapids, Michigan, USA.
  6. Mercy Health, Muskegon, Michigan, USA.
  7. Trinity Health, Livonia, Michigan, USA.
  8. Drexel College of Nursing and Health Professions, Philadelphia, Pennsylvania, USA.

PMID: 34314516 DOI: 10.1111/jgs.17383

Abstract

BACKGROUND: Programs to reduce disability are crucial to the quality of life for older adults with disabilities. Reducing disability is also important to avert unnecessary and costly hospitalizations, relocation, or nursing home placements. Few programs reduce disability and few have been replicated and scaled beyond initial research settings. CAPABLE is one such program initially tested in a randomized control trial and has now been tested and replicated in multiple settings. CAPABLE, a 10-session, home-based interprofessional program, provides an occupational therapist, nurse, and handyworker to address older adults' self-identified functional goals by enhancing individual capacity and home environmental supports. We examine evidence for the CAPABLE program from clinical trials embedded in different health systems on outcomes that matter most to older adults with disability.

METHODS: Six trials with peer-reviewed publications or reports were identified and included in this review. Participants' outcomes included basic and instrumental activities of daily living (ADLs, IADLs), fall efficacy, depression, pain, and cost savings.

RESULTS: A total of 1144 low-income, community-dwelling older adults with disabilities and 4236 matched comparators were included in the six trials. Participants were on average ≥74-79 years old, cognitively intact, and with self-reported difficulty with ≥1 ADLs. All six studies demonstrated improvements in ADLs and IADLs, with small to strong effect sizes (0.41-1.47). Outcomes for other factors were mixed. Studies implementing the full-tested dose of CAPABLE showed more improvement in ADLS and cost savings than studies implementing a decreased dose.

CONCLUSIONS: The CAPABLE program resulted in substantial improvements in ADLs and IADLs in all six trials with other outcomes varying across studies. A dose lower than the original protocol tested resulted in less benefit. The four studies examining cost showed that CAPABLE saved more than it costs to implement.

© 2021 The Authors. Journal of the American Geriatrics Society published by Wiley Periodicals LLC on behalf of The American Geriatrics Society.

Keywords: disability; health disparities; implementation

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