Impact of Educational and Professional Supportive Interventions on Nursing Home Quality Indicators (IQUARE)

This study is ongoing, but not recruiting participants.
Sponsor:
Collaborator:
Observatoire Régional de la Santé Midi-Pyrénées (ORSMIP)
Information provided by (Responsible Party):
Yves Rolland, University Hospital, Toulouse
ClinicalTrials.gov Identifier:
NCT01703689
First received: September 27, 2012
Last updated: October 9, 2012
Last verified: September 2012
  Purpose

Introduction: Efficacy of audit and feedback interventions on nursing home (NH)quality indicators is not well-established.

The main objective: The main purpose of the IQUARE study was to examine the impact of two types of audit and feedback interventions on NH quality indicators and on residents dependence levels in a 18-month follow-up.

Study hypothesis: We hypothesised that audit and feedback associated to educational and professional supportive interventions are more efficacy in improving NH quality indicators than audit and feedback only.

Secondary objectives: Investigate the impact of the interventions on

  1. Residents:

    • Functional decline rate
    • Drug prescriptions (quantity and quality)
    • Prevalence of adverse health outcomes (e.g., falls)
  2. NHs:

    • Planning and implementation of therapeutic measures

Condition Intervention
Quality Indicators
Physical Disability
Behavioral: Audit and Feedback
Behavioral: Cooperative Work

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Health Services Research
Official Title: Impact of Either Audit and Feedback Only or Audit and Feedback Associated to Cooperative Work Meetings Between Hospital Geriatricians and Nursing Home Staff on Quality Indicators and Health Care Practices in Nursing Homes.

Resource links provided by NLM:


Further study details as provided by Agence Régionale de la Santé - Midi Pyrénées:

Primary Outcome Measures:
  • Change from baseline in nursing home quality indicators at 18 months [ Time Frame: baseline and 18-month follow-up ] [ Designated as safety issue: No ]
    Indicators of quality of care in 10 main outcomes: dementia (e.g.,prevalence of cognitive assessment), behavioural disturbances (e.g., prevalence of behavioural disturbances assessment), restraining (e.g., prevalence of restrained residents with a medical prescription for restraining), mood (e.g., prevalence of mood assessment), osteoporosis and falls (e.g., systematic analysis of fall records), nutrition (e.g., prevalence of residents who were weighed ≥ 3 times in the last 3 months), pressure ulcers (e.g., prevalence of residents who were evaluated for the risk of pressure ulcers), pain (e.g., prevalence of residents who were evaluated for pain among residents in end-of-life), medication (e.g., prevalence of re-evaluation of residents' drug prescriptions among residents who take psychotropic), and care and services (e.g., prevalence of hospitalisations in the emergency department in the last 12 months).


Secondary Outcome Measures:
  • Onset of dependence in activities of daily living from baseline to 18 months follow-up [ Time Frame: baseline and 18-month follow-up ] [ Designated as safety issue: No ]
    Onset of dependence will be measured using the 6-item Katz ADL scale. Activities examined are: bathing, dressing, transferring, walking inside home, incontinence, and eating/drinking. Ability in executing each activity will be set as: "able to execute alone, without difficulty", "able to execute alone, with some difficulty", or "needing help to execute or unable to execute".


Other Outcome Measures:
  • Reduction in the prescription of psychotropic drugs from baseline to 18-month follow-up [ Time Frame: baseline and 18-month follow-up ] [ Designated as safety issue: No ]
    It will be examined if the rate of antidepressants, anxiolytics, antipsychotics, and hypnotics/sedatives (coded according to the Anatomical Therapeutic Chemical classification. Information available at: http://www.whocc.no/atc_ddd_index/) prescriptions will be reduced between baseline and follow-up. A particular attention will be given to the prevalence of people taking 3 or more psychotropics (increased risk of drug-drug interaction and adverse drug reaction) and to the use of these medications among people with dementia.


Estimated Enrollment: 6275
Study Start Date: May 2011
Estimated Study Completion Date: January 2013
Primary Completion Date: July 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: strong intervention group (SIG)
Nursing homes that received audit and feedback information on quality indicators and benefited of cooperative work meetings with hospital geriatricians
Behavioral: Audit and Feedback
Descriptive statistics to each nursing home (NH) with regards to its own indicators of quality and residents' health status, and the same descriptive statistics on the sub-regional and regional levels were done to all NHs for comparative purposes.
Behavioral: Cooperative Work
Nursing homes (NH)in the strong intervention group had two half-day meetings of cooperative work with a hospital geriatrician to identify NHs' weaknesses regarding quality of care and to establish strategies for overcoming these weaknesses.
Active Comparator: intervention group (LIG)
Nursing homes that only received audit and feedback information on quality indicators
Behavioral: Audit and Feedback
Descriptive statistics to each nursing home (NH) with regards to its own indicators of quality and residents' health status, and the same descriptive statistics on the sub-regional and regional levels were done to all NHs for comparative purposes.

Detailed Description:

IQUARE is a multicentric individually-tailored controlled trial comparing two types of audit and feedback interventions:

  • audit and feedback associated to cooperative work meetings between hospital geriatricians and nursing home (NH) staff in a 6-month intervention (strong intervention)
  • audit and feedback only (light intervention) Power statistics and sample size calculations indicated that each group should be composed of at least 2 500 individuals. The strong intervention will last 6 months and is composed of two face-to-face cooperative meetings (hospital geriatricians and NH staff). Data will be collected at baseline and in a 18-month follow-up.
  Eligibility

Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Nursing homes (NH) voluntarily accepted to participate in the study.
  • NH residents of both sex
  • Residents living in the NH for ≥ 30 days
  • Residents and their general practitioner (GP) having received information about the study
  • NH residents do not voluntarily decline to participate in the study

Exclusion Criteria:

  • NH currently participating in another interventional study
  • GP of NH residents refused participation in the study.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01703689

  Show 175 Study Locations
Sponsors and Collaborators
Agence Régionale de la Santé - Midi Pyrénées
Observatoire Régional de la Santé Midi-Pyrénées (ORSMIP)
Investigators
Principal Investigator: Yves Rolland, MD, PhD La Grave- Casselardit University Hospital Centre, Service de Médecine Interne et Gérontologie Clinique - Gérontopôle
  More Information

No publications provided

Responsible Party: Yves Rolland, MD PhD, University Hospital, Toulouse
ClinicalTrials.gov Identifier: NCT01703689     History of Changes
Other Study ID Numbers: ARSMP.2010.1
Study First Received: September 27, 2012
Last Updated: October 9, 2012
Health Authority: France: Ministry of Health
United States: Federal Government

Keywords provided by Agence Régionale de la Santé - Midi Pyrénées:
Quality indicators
quality of care
nursing home
long-term care unit
nursing home organisation
nursing home structure
disability
dependence
functional decline
functional impairment
older adults
elderly
audit and feedback
cooperative work
geriatrician
medication
hospitalisation
comorbidity

ClinicalTrials.gov processed this record on July 26, 2014