Improving Monitoring of Patients Receiving Case Management

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01597882
Recruitment Status : Completed
First Posted : May 14, 2012
Last Update Posted : February 19, 2014
Information provided by (Responsible Party):
Nicola Barnes, University of Southampton

Brief Summary:

The UK population is ageing and the likelihood of having a long term health condition increases with age. Three out of every five people over 60 in the UK have a long term condition. Ageing and having a long term condition increases the chance of having difficulty being independent and carrying out day to day activities. In recent years the NHS has made a greater effort to prevent these difficulties in patients with long term conditions.

One approach to help patients with long term conditions is case management, where by (usually) a community matron visits patients at home, looking for early warning signs of any worsening of their condition and arranging care and treatment. But the current way this is done varies across the country and hospital admissions are still rising. In order to give the right care at the right time, effective monitoring is needed to help the community matron detect and act on changes in the patient's condition.

Loss of muscle strength in old age is linked to a poor health, but it is not known whether simple measures of muscle strength could be used to detect and predict declines in health in the short to medium term to help maintain independence and prevent an accident or hospital admission.

The aim of this study is to look at whether monitoring muscle strength in case managed patients is practical, acceptable and useful in detecting when a patient's condition worsens. Each patient will be visited by the researcher in their home twice in the first week, then once every two weeks, for another 5 weeks, to carry out three simple measures of grip and respiratory strength, and complete questionnaires about their health and ability to carry out day to day activities. Each visit will last about 20 to 30 minutes. A small group of clinicians will be asked about their views of the strength measures. Database analysis will allow descriptive data on the patient group to be gathered and analysed.

Condition or disease
Multiple Conditions Coronary Heart Disease Diabetes Hypertension Chronic Obstructive Pulmonary Disease

Study Type : Observational
Actual Enrollment : 114 participants
Observational Model: Cohort
Official Title: Improved Targeting of Admission Avoidance Interventions in Older People With Long-term Conditions:An Observational,Longitudinal Study Exploring the Feasibility of Measures of Strength as a Monitoring Aid in Patients Receiving Case Management
Study Start Date : October 2012
Actual Primary Completion Date : December 2013
Actual Study Completion Date : December 2013

Case managed patients
Patients aged 65 years and over receiving community case management.

Primary Outcome Measures :
  1. Grip strength [ Time Frame: 13 weeks ]
    To assess reliability of measure over a one week period and the stability of the measure over 13 weeks, in this patient group, as well as acceptability.

Secondary Outcome Measures :
  1. Peak expiratory flow [ Time Frame: 13 weeks ]
    To measure reliability over one week and stability over 13 weeks in this patient group, as well as acceptability.

  2. Peak inspiratory flow [ Time Frame: 13 weeks ]
    To assess reliability over one week, and stability over 13 weeks in this patient group, as well as acceptability.

  3. Sickness behaviour scale [ Time Frame: 13 weeks ]
    To explore the relationship between sickness behaviour and measures of strength.

Information from the National Library of Medicine

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Ages Eligible for Study:   65 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
Patients receiving cmmunity health case management.

Inclusion Criteria:

  • Patients aged 65 years or over receiving health case management in the community.

Exclusion Criteria:

  1. Enrolled in any other research study
  2. Preclude consent:

    • Significant cognitive impairment resulting in lack of capacity to consent. b. Unable to communicate without significant aids e.g. Non-English speaking.
  3. Preclude participation/ collection of data

    • Significant emotional distress or psychotic illness active within the last 6 months.
    • Receiving end of life care.
    • Current illness that would preclude data collection.
    • Upper limb pathology that would limit participation e.g. bone fracture within the previous 6 months.
    • Identified as high risk patients with regards to lone working safety by their case manager.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01597882

United Kingdom
Solent NHS Trust
Portsmouth, United Kingdom, PO4 8LD
Southern Health NHS Foundation Trust
Southampton, United Kingdom, PO13 0FH
Sponsors and Collaborators
University of Southampton
Principal Investigator: Nicola Barnes, MPharm University of Southampton

Responsible Party: Nicola Barnes, Post-graduate Research Student, University of Southampton Identifier: NCT01597882     History of Changes
Other Study ID Numbers: 8550
1409-ERGO ( Other Identifier: University of Southampton )
First Posted: May 14, 2012    Key Record Dates
Last Update Posted: February 19, 2014
Last Verified: February 2014

Keywords provided by Nicola Barnes, University of Southampton:
case management
long term conditions
aged sixty five and over

Additional relevant MeSH terms:
Lung Diseases
Lung Diseases, Obstructive
Pulmonary Disease, Chronic Obstructive
Heart Diseases
Coronary Disease
Coronary Artery Disease
Myocardial Ischemia
Respiratory Tract Diseases
Cardiovascular Diseases
Pathologic Processes
Vascular Diseases
Arterial Occlusive Diseases