Lee Jessica L, Burnett Jason, Xia Rui, Smith Scott M, Dyer Carmel B
a Division of Geriatric and Palliative Medicine; Texas Elder Abuse and Mistreatment (TEAM) Institute; and UTHealth Consortium on Aging , The University of Texas Health Science Center at Houston (UTHealth).
b UTHealth Division of Geriatric and Palliative Medicine ; TEAM Institute.
J Elder Abuse Negl. 2018 Mar;30(3):223-235. doi: 10.1080/08946566.2018.1450172. Epub 2018 Mar 22.
Interventions are critical to improving clinical outcomes in elder self-neglecters. This study assessed feasibility of a randomized controlled trial of oral vitamin D in Adult Protective Services-substantiated self-neglect clients ≥65 years.
Participants were directly observed to consume ergocalciferol 50,000 IU (treatment) or ergocalciferol 400 IU (control), once a month, for 10 months. For months 6-10, half the control group randomly crossed into the treatment group (crossover). Intervention feasibility was measured by number of potential participants who agreed to participate and by retention rates during the study.
Ninety-four referrals were received and 59 (63%) agreed to participate. Forty-nine participants were enrolled after prescreening and 35 completed the two-phase trial for a 72% retention rate. The participants' average age was 75.2 ± 6.8 years, mainly female (59%), African-American (47%), and living alone (41%).
Despite assumptions that self-neglecters are resistant to care, we have successfully conducted the first clinical intervention in this vulnerable population.
干预措施对于改善老年自我忽视者的临床结局至关重要。本研究评估了一项针对65岁及以上经成人保护服务机构证实存在自我忽视的患者进行口服维生素D随机对照试验的可行性。
直接观察参与者每月服用一次50,000国际单位麦角钙化醇（治疗组）或400国际单位麦角钙化醇（对照组），持续10个月。在第6至10个月期间，对照组的一半随机转入治疗组（交叉）。通过同意参与的潜在参与者数量和研究期间的留存率来衡量干预的可行性。
共收到94份转诊申请，59人（63%）同意参与。49名参与者经过预筛选后入组，35人完成了两阶段试验，留存率为72%。参与者的平均年龄为75.2±6.8岁，主要为女性（59%）、非裔美国人（47%）且独自生活（41%）。
尽管有人认为自我忽视者抗拒护理，但我们已成功对这一弱势群体进行了首次临床干预。
