Topic: Primary Care Research Network for England, Generic Health Relevance and Cross Cutting Themes
Conditions
Interventions
Interventions as of 09/11/2016:
Participants are randomly allocated to intervention or control group following consent.
Intervention arm: This involves a service deliv
Study Entry : Single Randomisation only
Sponsors
King's College London (UK)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Phase 1b: focus groups - Older adults living with frailty using one of the participating community groups or residing in the participating care home; or carers of older adults. Carers are either informal carers e.g. family member or a carer working as a volunteer for one of the participating charitable organisation supporting older people in community settings. Adults with capacity to give informed consent and communicate in English. 2. Stakeholder consultation participants comprise: service providers, commissioners and voluntary sector representatives from the study site. The purposive selection on the participants is based on: The services providers are health or social care practitioners providing community based services including: specialist palliative care, general practice, community nursing, end of life care facilitators, dementia services and social care. 3. The practitioners provide services in the locality of Sussex Community NHS Trust. 4. The commissioners are leads for end of life care services and are identified from the Care Commissioning Groups in the study site. 5. Voluntary sector representatives are local individuals representing local/national organisations supporting/advocating for older people. Phase 2: Adults aged 75 years over residing in the study site at home or in a care home (with or without nursing) severely affected by non-malignant advanced illness and/ frailty with or without dementia and not using specialist palliative care. Severely affected encompasses one or more unresolved symptoms, psychosocial concerns, EoL issues, progressive illness, complex needs or Gold Standards Framework (GSF) prognostication index for frailty and dementia. Participants are registered with one of the four GP practices participating in the study. Participation will be offered to older people with or without carers. The inclusion criteria are broad as uncertainty surrounds when a frail older person may most benefit from palliative care. The findings from phases 1a and 1b will further develop and refine the inclusion criteria.
Exclusion criteria
Exclusion criteria: Phase 2: Exclusion criteria Older people with malignant disease receiving curative or palliative treatment .
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 5 key symptoms are measured using the integrated Palliative care Outcome Scale at baseline, 6 weeks and 12 weeks (primary end point). | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Assistance with activities of daily living is measured using the Barthel Index at baseline and 12 weeks 2. Performance status is measured using the Australia Karnofsky Index at baseline and 12 weeks 3. Carer burden is measured using the Zarit carer burden at baseline and 12 weeks 4. Service use and cost is measured/calculated using the Client Service Receipt Inventory at baseline and 12 weeks 5. Survival is measured by reviewing GP medical records for mortality at 12 weks | — |
Countries
United Kingdom
Outcome results
None listed