A Clinical Pathway for Nursing Home Acquired Pneumonia

This study has been completed.
Sponsor:
Collaborator:
Canadian Institutes of Health Research (CIHR)
Information provided by:
McMaster University
ClinicalTrials.gov Identifier:
NCT00157612
First received: September 7, 2005
Last updated: July 19, 2006
Last verified: September 2005
  Purpose

Nursing home residents are frequently transferred to hospital for management of pneumonia. This often leads to hospital related complications and is a burden on the acute care health system. The purpose of this study is to assess whether managing residents with pneumonia and lower respiratory tract infection on site in the nursing home can reduce hospital admissions and can reduce complications and improve quality of life for residents. We have randomized residents with nursing home acquired pneumonia to on-site management, using a clinical pathway, versus usual care.


Condition Intervention
Pneumonia
Lower Respiratory Tract Infection
Procedure: a clinical pathway for the management of nursing home acquired pneumonia

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Randomized Control Trial of a Clinical Pathway for Nursing Home Pneumonia.

Resource links provided by NLM:


Further study details as provided by McMaster University:

Primary Outcome Measures:
  • Hospital admission, length of stay

Secondary Outcome Measures:
  • Health related quality of life,
  • complication rates,
  • mortality,
  • functional status,
  • time to stabilization of vital signs

Estimated Enrollment: 680
Study Start Date: January 2001
Estimated Study Completion Date: July 2005
Detailed Description:

We conducted a cluster-randomized controlled trial where nursing homes were randomized to either use of a clinical pathway or usual care for management of nursing home acquired pneumonia. The clinical pathway included chest radiographs performed on-site in the nursing home by a mobile x-ray unit, use of hypodermocylysis (subcutaneous infusion) for re-hydration, administration of an oral antimicrobials, and use of pulse oximetry to assess oxygenation. The main outcomes were hospital admission rate and length of stay. Secondary outcomes included health related quality of life, rates of both infectious and non-infectious complications within four weeks of onset of symptoms; mortality rate of residents with pneumonia (death from all causes within 30 days of onset of symptoms. Time to stabilization of vital signs, as well as functional status at four weeks, were assessed.

  Eligibility

Ages Eligible for Study:   64 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Symptoms or signs of lower respiratory tract infection as defined by standardized criteria.

Exclusion Criteria:

  • Residents were excluded if they were not expected to live longer than 30 days from the date of enrollment, had a previous anaphylactic or serious allergic reaction to quinolones, had advanced directives that they are not be transferred to hospital for treatment.
  Contacts and Locations
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Please refer to this study by its ClinicalTrials.gov identifier: NCT00157612

Sponsors and Collaborators
Hamilton Health Sciences Corporation
Canadian Institutes of Health Research (CIHR)
Investigators
Principal Investigator: Mark B Loeb, MD MSc FRCPC McMaster University
  More Information

Publications:
ClinicalTrials.gov Identifier: NCT00157612     History of Changes
Other Study ID Numbers: 00-1848, CRT-43826
Study First Received: September 7, 2005
Last Updated: July 19, 2006
Health Authority: Canada: Health Canada

Keywords provided by McMaster University:
pneumonia
lower respiratory tract infection
clinical pathway
nursing home
long-term care
randomized control trial

Additional relevant MeSH terms:
Pneumonia
Respiratory Tract Infections
Lung Diseases
Respiratory Tract Diseases
Infection

ClinicalTrials.gov processed this record on August 19, 2014