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Anticipatory & Preventive Team Care (APTCare): At Risk Patients of Family Health Networks

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ClinicalTrials.gov Identifier: NCT00238836
Recruitment Status : Unknown
Verified June 2005 by C. T. Lamont Primary Care Research Centre.
Recruitment status was:  Active, not recruiting
First Posted : October 14, 2005
Last Update Posted : October 13, 2006
Information provided by:

Study Description
Brief Summary:
The University of Ottawa and Élisabeth Bruyère Research Institute are conducting a study of preventive care for frail patients at risk of functional decline. At risk patients are assigned by chance to continue receiving their standard care from their family physician or receive additional care from a nurse practitioners and a pharmacist. In collaboration with the family physician, they develop an individualized care plan, a treatment and management road plan, for each patient, which they implement over the study period of one approximately year. The objective of the study is to compare the effectiveness of the model of care that includes the nurse practitioners and pharmacist against standard care in preventing functional decline, to determine the acceptability of this model of care to patients, their caregivers and the medical team, and to evaluate the cost implication of the program.

Condition or disease Intervention/treatment Phase
Diabetes Chronic Obstructive Pulmonary Disease Congestive Heart Failure Hypertension Behavioral: Self-management of chronic illness Phase 2 Phase 3

Study Design

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 240 participants
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Prevention
Estimated Study Completion Date : March 2006
Arms and Interventions

Outcome Measures

Eligibility Criteria

Information from the National Library of Medicine

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Ages Eligible for Study:   50 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • 50 years and over
  • 'At Risk' by having one or more of the following: a. Visits to emergency dept within the past 6 months; b. Admission to hospital for a medical problem in past 6 months; c. High service use profiles; d. Polypharmacy; e. Other high risk factors
  • Capable of giving informed consent
  • Able to use the Care Companion technology

Exclusion Criteria:

  • Cognitive impairment such that they cannot give informed consent
  • Unable or unwilling to use the telehomecare equipment
  • Unlikely to tolerate the intensive intervention
  • Language or cultural barriers
  • Being acutely ill or having an unstable condition on entry to the study
Contacts and Locations

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 ClinicalTrials.gov identifier (NCT number): NCT00238836

Canada, Ontario
West Carleton Family Health Network
Carp, Ontario, Canada, K0A 1L0
Sponsors and Collaborators
C. T. Lamont Primary Care Research Centre
Ontario Ministry of Health and Long Term Care
University of Ottawa
Principal Investigator: William Hogg, MD C. T. Lamont Primary Care Research Centre
Principal Investigator: Jacques Lemelin, MD University of Ottawa
More Information