Provision of a Mobile Geriatric Team Extra-Community Hospital (UMG)

• ClinicalTrials.gov Identifier: NCT01449968
• Recruitment Status: Completed
• First Posted: October 10, 2011
• Last Update Posted: April 28, 2014
• Sponsor: University Hospital, Grenoble
• Information provided by (Responsible Party): AdministrateurCIC, University Hospital, Grenoble

Study Description

Brief Summary:

The purpose of this study is to demonstrate the effectiveness of the mobile unit to reduce the geriatric hospital inappropriate (especially for emergencies) to 1 month.

The primary endpoint: survival without hospitalization through the emergency inappropriate to 1 month.

Condition or disease	Intervention/treatment
Geriatric Disorder; Mobil Unit	Other: home visit; Other: telephone management

Detailed Description:

The purpose of this study is to assess the effectiveness of the Mobile Geriatrics on the management of complex situations in retirement homes and in ambulatory care of frail elderly patients, reported by the generalist doctor, in terms of improving the conditions of use technical support hospital follow-up recommendations given by the mobile team and their impact on outcomes of care.

Study Design

• Study Type: Observational
• Actual Enrollment: 334 participants
• Observational Model: Cohort
• Time Perspective: Prospective
• Official Title: Provision of a Mobile Geriatric Team Extra-Community Hospital in Assessing and Regulating the Hospitalization of Frail Elderly Patients With Complex Medical and Social Situation
• Study Start Date: June 2011
• Actual Primary Completion Date: May 2013
• Actual Study Completion Date: November 2013

Groups and Cohorts

Group/Cohort	Intervention/treatment
home visit of UMG; home visit with evaluation and management of the situation (control over in-home telephone)	Other: home visit; home visit of UMG
telephone management; geriatric mobile unit provides a telephone advice only to the general practitioner with guidance and recommendations (call control)	Other: telephone management; telephone management of the situation reported by the patient's GP; Other Name: telephone management of the mobile unit of Geriatrics

Outcome Measures

Primary Outcome Measures :

1. effectiveness of the visit of the mobile unit to reduce the geriatric hospital inappropriate (especially for emergencies) to 1 month [ Time Frame: 1 month ]
   inappropriate survival without hospitalization through the emergency room at 1 month

Secondary Outcome Measures :

1. follow-up rate of the proposals of UMG ext (adherence to recommendations and feasibility) and analyze the reasons for not monitoring these proposals one month [ Time Frame: 1 month ]
   follow-up of recommendations made by the mobile unit of Geriatrics
2. survival without hospitalization inappropriate, mortality, changes in functional status and cognitive health care consumption up to 6 months of surgery [ Time Frame: 6 months ]
   Unplanned hospitalization rates obtained by telephone follow-up at 3 and 6 months
3. effectiveness of the visit of the mobile geriatric home versus telephone follow-up of mobile geriatric unit [ Time Frame: 6 months ]
   Analysis of sub-groups
4. needs and difficulties of attending physicians in the care of frail elderly patients with complex medical and social situation before and after the establishment of mobile units for geriatrics. [ Time Frame: 1 year ]
   Questionnaire to GPs in the health sector concerned
5. cost effectiveness of two types of visit of the mobile unit of Geriatrics (telephone regulation and control over travel home phone) [ Time Frame: 6 months ]
   Cost of hospitalization.

Eligibility Criteria

• Ages Eligible for Study: 75 Years and older (Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No
• Sampling Method: Non-Probability Sample

Study Population

The study population includes patients over 75 years in medical condition or psycho-social complex, followed by a general practitioner to population centers include: Grenoble, Annecy and Roanne.

Criteria

Inclusion Criteria:

• Patient aged 75 and over living in complex medical or psycho-social complex or at risk of hospitalization
• Patient affiliated to social security or beneficiary of such a regime
• Patient available for follow-up to 6 months with a caregiver or accompanying social duly appointed.

Exclusion Criteria:

• Patient residing outside intervention sector
• Life-threatening emergency (ambulance)
• Lack of complexity of the situation, supported by routine care

Contacts and Locations

Locations

France

CH Annecy

Annecy, France, 74000

University Hospital of Grenoble

Grenoble, France, 38000

CH Roanne

Roanne, France, 42300

Sponsors and Collaborators

University Hospital, Grenoble

Investigators

• Principal Investigator: Pascal COUTURIER, PUPH; Geriatric unit - University Hospital of Grenoble

More Information

Publications:

Bernabei R, Landi F, Gambassi G, Sgadari A, Zuccala G, Mor V, Rubenstein LZ, Carbonin P. Randomised trial of impact of model of integrated care and case management for older people living in the community. BMJ. 1998 May 2;316(7141):1348-51.

Stuck AE, Siu AL, Wieland GD, Adams J, Rubenstein LZ. Comprehensive geriatric assessment: a meta-analysis of controlled trials. Lancet. 1993 Oct 23;342(8878):1032-6.

Elkan R, Kendrick D, Dewey M, Hewitt M, Robinson J, Blair M, Williams D, Brummell K. Effectiveness of home based support for older people: systematic review and meta-analysis. BMJ. 2001 Sep 29;323(7315):719-25. Review.

• Responsible Party: AdministrateurCIC, Pr Pascal COUTURIER, University Hospital, Grenoble, University Hospital, Grenoble
• ClinicalTrials.gov Identifier: NCT01449968
• Other Study ID Numbers: DCIC 10 16
• First Posted: October 10, 2011
• Last Update Posted: April 28, 2014
• Last Verified: April 2014