Improving Monitoring of Patients Receiving Case Management
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.
|Multiple Conditions Coronary Heart Disease Diabetes Hypertension Chronic Obstructive Pulmonary Disease|
|Study Design:||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|
- 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.
- 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.
- 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.
- Sickness behaviour scale [ Time Frame: 13 weeks ]To explore the relationship between sickness behaviour and measures of strength.
|Study Start Date:||October 2012|
|Study Completion Date:||December 2013|
|Primary Completion Date:||December 2013 (Final data collection date for primary outcome measure)|
Case managed patients
Patients aged 65 years and over receiving community case management.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01597882
|Solent NHS Trust|
|Portsmouth, United Kingdom, PO4 8LD|
|Southern Health NHS Foundation Trust|
|Southampton, United Kingdom, PO13 0FH|
|Principal Investigator:||Nicola Barnes, MPharm||University of Southampton|