Efficacy of Integrated Care to Reduce Hospitalization and Nursing Home Placement in Community Dwelling Frail Elderly
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|ClinicalTrials.gov Identifier: NCT02084108|
Recruitment Status : Completed
First Posted : March 11, 2014
Last Update Posted : March 11, 2014
Introduction: Care of frail and dependent elders with multiple chronic conditions is a major challenge for health care systems. The objective of this study is to evaluate the effect of coordinating the existing structures in the private and public sector for the care of frail and dependent persons over age 60, and susceptible of presenting complex bio-psycho-social issues. This approach is aimed at improving the coordination, continuity, quality and efficacy of care in this population, which presents a high risk of hospitalization, emergency room visits, institutionalization and mortality.
Methods: Three-year cluster randomised controlled trial. A control group receiving usual care (follow up by primary care physician and home nursing service) will be compared to an intervention group that will be provided, in addition, in-home multidimensional geriatric assessment with access to a 24h/7 day a week call service, and coordinated long-term follow-up. Survival analyses will be conducted to compare the outcomes between groups.
- Hospitalizations: rates of first hospitalization, number, cause and length of stay.
- Emergency room visits: rates of first visit, number and cause
- Institutionalization: number of patients
- Mortality: rate and number of deaths and place of death (home versus hospital)
|Condition or disease||Intervention/treatment||Phase|
|Chronic Diseases||Other: intervention||Not Applicable|
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||301 participants|
|Intervention Model:||Parallel Assignment|
|Masking:||None (Open Label)|
|Primary Purpose:||Health Services Research|
|Official Title:||Efficacy of Integrated Care to Decrease Hospitalization and Institutionalization in Community Dwelling Frail Elderly, With Care Coordination Between Physicians, Home Nursing Services and a Community Geriatrics Unit.|
|Study Start Date :||July 2009|
|Actual Primary Completion Date :||December 2012|
|Actual Study Completion Date :||December 2012|
No Intervention: Control arm= usual care
Two clusters of patients over 60 years of age followed by a primary care physician and routinely evaluated by the home nursing service with the resident assessment instrument-home care (RAI-HC) and identified as frail by pre-defined clinical criteria.
The intervention arm will consist of two clusters of patients over 60 years of age followed by a primary care physician and routinely evaluated by the home nursing service with the RAI-HC and identified as frail by predefined clinical criteria that will receive in addition an in-home multidimensional geriatric assessment, access 24 hours a day, 7 days a week to a call service provided by the Community Geriatrics Unit and coordinated long-term follow-up.
intervention group that will be provided, in addition, in-home multidimensional geriatric assessment with access to a 24h/7 day a week call service, and coordinated long-term follow-up.
- Hospitalizations: rates of first hospitalization, number and reason [ Time Frame: Three years ]
- Emergency room visits: rates of first visit, number and cause. [ Time Frame: Three years ]
- Institutionalization: number of patients [ Time Frame: Three years ]
- Mortality: rate and number of deaths and place of death (home versus hospital) [ Time Frame: Three years ]
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 ClinicalTrials.gov identifier (NCT number): NCT02084108
|University hospital of Geneva|
|Geneva, Switzerland, 1211|