This site became the new on June 19th. Learn more.
Show more Menu IMPORTANT: Listing of a study on this site does not reflect endorsement by the National Institutes of Health. Talk with a trusted healthcare professional before volunteering for a study. Read more... Menu IMPORTANT: Talk with a trusted healthcare professional before volunteering for a study. Read more... Menu
Give us feedback

Continuum of Care for Frail Elderly People

This study has been completed.
Information provided by (Responsible Party):
Vardalinstitutet The Swedish Institute for Health Sciences Identifier:
First received: November 30, 2010
Last updated: June 11, 2014
Last verified: June 2014

The present study "Continuum of care for frail elderly people" form part of the research programme "Support for frail elderly persons - from prevention to palliation" ( which comprises research into three interventions. The program comprises interventions addressing frail elderly people in different phases of the disablement process, from elderly people who are beginning to develop frailty to very frail elderly people receiving palliative care.

The intervention "Continuum of care for frail elderly people" addresses elderly people who are frail and that have a great risk of high health care consumption. The hypothesis is that an intervention program for frail elderly people can reduce the number of visits to the emergency department, increase the life satisfaction and maintain the functional ability. The intervention, including an early geriatric assessment at the emergency department, early family support, a case manager in the community with a multi-professional team and active follow-up by the case manager, contributes to early recognition of the elderly people's need of information, care and rehabilitation and of informal caregivers' need of information. It enhances the transfer of information and integrates the care between different caregivers and different care levels, thereby better recognize frail elderly people's needs. Specifically, this study is expected to show that the intervention has a positive effect on the frail elderly person's functional ability, life satisfaction, satisfaction with health and social care, and health care consumption.

Condition Intervention
Frail Elderly People Other: integrated health care chain

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Supportive Care
Official Title: Continuum of Care, From the Emergency Ward to Living at Home - Implementation and Evaluation of an Intervention for Frail Elderly People

Further study details as provided by Vardalinstitutet The Swedish Institute for Health Sciences:

Primary Outcome Measures:
  • Health Care Consumption [ Time Frame: 1 year ]
    Number of hospital days and admission will be analysed

  • Dependence in Activities of Daily Living [ Time Frame: 1 year ]
    Changes in number of person dependent in one or more daily activity from baseline to follow-up.

  • Satisfaction With Health and Social Care [ Time Frame: 1 year ]

Enrollment: 181
Study Start Date: October 2008
Study Completion Date: October 2011
Primary Completion Date: June 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
No Intervention: Conventional care, controlgroup
conventional care, control group
Experimental: integrated health care chain
integrated health care chain. Geriatric assessment at emergency department (ED), case manager with multiprofessional team in the community, support for informal caregivers
Other: integrated health care chain
Geriatric assessment at ED, case manager with multiprofessional team in the community, support for informal caregivers


Ages Eligible for Study:   65 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • 80 years and older or 65 to 79 years and having at least one chronic disease and being dependent in at least one activity of daily living

Exclusion Criteria:

  • acute severely sick who immediately needs the assessment of a physician (within ten minutes)
  • those with diagnosis of dementia (or severe cognitive impairment)
  • patients in palliative care
  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 identifier: NCT01260493

University of Gothenburg
Gothenburg, Sweden, 405 30
Sponsors and Collaborators
Vardalinstitutet The Swedish Institute for Health Sciences
Principal Investigator: Katarina Wilhelmson, MD,PhD Göteborg University
  More Information