Evaluation of the Singapura Program of All Inclusive Care for the Elderly (SingaPACE) Demonstration Project
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Purpose
This is a RCT studying the effectiveness of the Singapore Program for All Inclusive Care for the Elderly (SingaPACE) demonstration project over a 36 month period. SingaPACE is modelled on the US PACE home and community based service that acts as an alternative to institutional care. The comparator is best referrals for care as currently arranged through the Agency for Integrated Care (AIC) and referred by medical social workers. This research aims to determine how the SingaPACE model of health and social care affects use of emergency and acute care hospital services, institutional care, the quality of life (QOL) and satisfaction of the participants aged 60+ and their caregivers.
The hypotheses to be tested are:
H01: The elderly in SingaPACE will have fewer admissions to accident & emergency (A&E) hospitalization than the elderly who are not in SingaPACE.
H02: The elderly in SingaPACE will have fewer admissions to acute care hospitalization than the elderly who are not in SingaPACE.
H03: The elderly in SingaPACE will delay first admission to institutionalized nursing home care more than the elderly who are not in SingaPACE.
H04: The elderly in SingaPACE clients will have a higher QOL compared to the elderly who are not in SingaPACE.
H05: Caregivers of the elderly in SingaPACE will have a lower care-giving burden compared to caregivers of the elderly who are not in SingaPACE.
| Condition | Intervention |
|---|---|
|
Frail Elders |
Behavioral: SingaPACE |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Investigator, Outcomes Assessor) Primary Purpose: Health Services Research |
| Official Title: | Evaluation of the Singapura Program of All Inclusive Care for the Elderly |
- Number of EMT and acute care events [ Time Frame: 36 months ] [ Designated as safety issue: No ]
The primary outcome measure will be the number of EMT events, A&E visits or acute care hospitalizations captured based on the following possible sequence of events:
- The number of EMT events or
- The number of EMT events leading to A&E events or
- The number of EMT events leading to A&E events that lead to acute care hospitalizations or
- The number of A&E events or
- The number of A&E events that lead to acute care hospitalizations or
- The number of acute care hospitalizations
- Admission to institutionalized nursing home [ Time Frame: 36 months ] [ Designated as safety issue: No ]From randomization point, time to first admission to nursing home over the 36 month period
- Length of stay in acute care [ Time Frame: 36 months ] [ Designated as safety issue: No ]For each acute care hospitalization, the length of stay
- Patient Quality of Life [ Time Frame: 36 months ] [ Designated as safety issue: No ]Patient QOL assessed using EQ-5D at 6 month intervals for the given time frame
- Caregiver burden [ Time Frame: 36 months ] [ Designated as safety issue: No ]Using the Zarit Caregiver Burden measure, assess changes to caregiver (spouse, family members, friends) burden at 6 month intervals for the given time frame
| Estimated Enrollment: | 80 |
| Study Start Date: | August 2011 |
| Estimated Study Completion Date: | October 2014 |
| Estimated Primary Completion Date: | October 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
No Intervention: Control Group
Individuals randomized into the control arm will receive usual community care services referred by the social worker from SGH and AH.
|
|
|
Experimental: Intervention Group
Individuals in the intervention group will go through an integrated program of community based health and social care based on intake and ongoing evaluation by the SingaPACE team.
|
Behavioral: SingaPACE
Individuals in the intervention group will go through an integrated program of community based health and social care, based on intake and ongoing evaluation by the SingaPACE team.
Other Name: SingaPACE
|
Show Detailed Description Eligibility| Ages Eligible for Study: | 60 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- Individuals aged 60 and above;
- The frail elderly classified as high Category2 - Category 3 under the Residence Assessment Form(RAF);
- Are willing to enroll in SingaPACE if they were selected in a fair lottery draw or to be followed up similarly over 36 months if not selected;
- Residing within the Bukit Merah catchment area;
Exclusion Criteria:
- Bed Bound;
- Are undergoing dialysis treatment,
- Radiotherapy or chemotherapy; or
- Have behavioral and psychological symptoms of dementia(BPSD)prior to enrollment in the research study.
Contacts and Locations| Singapore | |
| Tiong Bahru Central Plaza | |
| Singapore, Singapore | |
| NTUC Eldercare | |
| Singapore, Singapore | |
| Principal Investigator: | David B Matchar, MD,FACP,FAHA | Duke-NUS Graduate Medical School Singapore |
More Information
No publications provided
| Responsible Party: | Dr. David Matchar, Professor, National University, Singapore |
| ClinicalTrials.gov Identifier: | NCT01568801 History of Changes |
| Other Study ID Numbers: | 2011/381/A, 2011/381/A |
| Study First Received: | March 29, 2012 |
| Last Updated: | December 17, 2012 |
| Health Authority: | Singapore: Domain Specific Review Boards |
Keywords provided by National University, Singapore:
|
Integrated Services Health Services for the Elderly Community Services |
ClinicalTrials.gov processed this record on May 16, 2013