Topic: Mental Health Research Network
Conditions
Interventions
Comprehensive Geriatric Assessment:
Once consent and the baseline data and beside measurements have been collected, the participants will be allocated to the intervention or the control arm (usual ca
Sponsors
University of Nottingham (UK)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Patient participant: 1. Attending and being discharged from the Acute Medical Unit at Queen's Medical Centre, Nottingham or Leicester Royal Infirmary, Leicester 2. Aged 70 years or over, either sex 3. Identified as being at high risk of adverse outcomes using the Identification of Seniors At Risk (ISAR) score When the decision to discharge the patient has been made, usually by duty consultant, the Multidisciplinary Team responsible for making the discharge arrangements will identify all those who are 70 years old or over who score positive on the ISAR score and are living within the usual catchment area of the hospital and indicate them to the study researcher. Patients with potential exceptional reasons for non-recruitment will be discussed with the researcher. These methods have worked successfully in a related cohort study run on the unit in Nottingham already. Carer participant: 4. Identified as carer of a patient participant; any carer present with the patient participant will be invited to be a carer participant for the study. If a carer participant is not present on the AMU but known to exist, an invitation and information sheet, consent form and questionnaire will be given to the patient participant.
Exclusion criteria
Exclusion criteria: 1. Patient without capacity where there is no consultee available 2. Any exceptional reason cited by the AMU should not be recruited (e.g. dangerous) 3. Patient not resident in normal hospital catchment area
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Number of days spent at home over 90 days of follow up, defined as 90 days or the number of days from discharge until death, minus the number of days spent in residential intermediate care units, days in hospital due to unplanned readmission (community hospital, psychiatric hospital or other acute hospital), or the number of days spent in a new care home placement. These outcomes will be ascertained from a variety of existing databases, including primary care, social care and secondary care systems. The validity of this approach will be tested in the pilot phase, comparing self reported days at home against those recorded in the various databases. | — |
Secondary
| Measure | Time frame |
|---|---|
| Outcomes will be collected at 90 days and will include an array of validated outcomes, which will be ascertained by examination of the above databases, by postal questionnaire or by individual interviews if required: 1. Death 2. Institutionalisation 3. Hospital use (Emergency Department, AMU admissions, clinics) 4. Personal Activities of Daily Living (Barthel ADL Index) 5. Self reported falls over previous 90 days 6. Medication audit against STOPP/START criteria at 90 days 7. Psychological wellbeing (General Health Questionnaire [GHQ12]) 8. Quality of life (EuroQoL EQ5D) and ICECAP 9. Resource use 10. Carer strain: Caregiver Strain Index 11. Carer generic quality of life: EuroQol EQ5D 12. Carer specific quality of life: CQLIR | — |
Countries
United Kingdom
Outcome results
None listed