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In their review of the different models of integrated care tried in Quebec over the last decade, the authors mention the PRISMA experiment and report that “the results on impact on functional decline were inconclusive” [2, p. 5]. This is not true since the main outcome of this four-year quasi-experimental study involving more than 1500 subjects was a statistically significant 6.2% reduction in the prevalence of functional decline (p<0.05) and a 13.7% decrease in the incidence of functional decline (p<0.01) in the experimental groups as compared to the comparison groups [3]. Functional decline in this study was defined as a five-point or more decrease on the disability scale, institutionalization or death. This indicator has been used previously in other studies [4, 5]. Moreover, participants with unmet needs, i.e. presenting disabilities not addressed by adequate resources or services, were 31.4% lower in the experimental groups in the fourth year of the study (p<0.001). These results are very conclusive since it was a population-based study designed to measure effectiveness not efficacy. The subjects were randomly selected from people 75 years and older at risk of functional decline, who did not necessarily benefit from the tested integrated care model during the study period. In fact, only 18% of the subjects were assessed and cared for by a case manager in the experimental groups during the study period.

Special 10th anniversary edition. PRISMA: a good example of transferring research evidence into public policy