Comprehensive geriatric assessment in a HAH setting

Conditions

Topic: Primary Care, Ageing

Sasha Shepperd, Andrea Cradduck-Bamford, Christopher Butler, Graham Ellis, Mary Godfrey et al. (20 authors)

Health and Social Care Delivery Research2022-01-0131 citations

Is Comprehensive Geriatric Assessment Admission Avoidance Hospital at Home an Alternative to Hospital Admission for Older Persons? : A Randomized Trial.

Shepperd S, Butler C, Cradduck-Bamford A, Ellis G, Gray A, Hemsley A, Khanna P, Langhorne P, Mort S, Ramsay S, Schiff R, Stott DJ, Wilkinson A, Yu LM, Young J.

2021-04-2074 citations

10.7326/m20-5688

A protocol for the process evaluation of a multi-centre randomised trial to compare the effectiveness of geriatrician-led admission avoidance hospital at home versus inpatient admission.

Mäkelä P, Godfrey M, Cradduck-Bamford A, Ellis G, Shepperd S.

2018-10-193 citations

10.1186/s13063-018-2929-4

A multi-centre randomised trial to compare the effectiveness of geriatrician-led admission avoidance hospital at home versus inpatient admission.

Shepperd S, Cradduck-Bamford A, Butler C, Ellis G, Godfrey M, Gray A, Hemsley A, Khanna P, Langhorne P, McCaffrey P, Mirza L, Pushpangadan M, Ramsay S, Schiff R, Stott D, Young J, Yu LM.

2017-10-2325 citations

10.1186/s13063-017-2214-y

Interventions

CGA in hospital at home: Admission avoidance HaH with CGA is a specialist led service providing assessment and a tailored management plan, multidisciplinary management and coordinated care in the pati

Follow Up Length: 12 month(s)

Study Entry : Single Randomisation only

Eligibility

Sex/Gender

All

Inclusion criteria

Inclusion criteria: Older patients with frailty who are aged >65 years and who have been referred to the admission avoidance HaH service with CGA and who would otherwise require admission to hospital for an acute medical event. This will include patients presenting with delirium, functional decline, dependence, falls, immobility or a background of dementia presenting with physical disease

Exclusion criteria

Exclusion criteria: 1. Patient with acute coronary syndrome 2. Patients needing acute surgical assessment 3. Patients presenting with a suspected stroke 4. Patients who are receiving end of life care as part of a palliative care pathway 5. Patients who refuse the HaH service 6. Patients considered by the clinical staff to be too high risk for home based care, for example those who are physiologically unstable, who are at risk to themselves or if the carer reports HaH care would not be acceptable (in keeping with existing clinical practices for HaH) 7. The presence of a carer will not be a requirement for enrolment and will depend on the individual circumstances of the patient; this will be at the discretion of the clinician responsible for the patient (as is current clinical practice in each centre)

Design outcomes

Primary

Measure	Time frame
Living at home; Timepoint(s): 6 and 12 months	—

Secondary

Measure	Time frame
1. Activities of daily living; Timepoint(s): 6 and 12 months 2. Cognitive impairment; Timepoint(s): 6 and 12 months 3. Delirium; Timepoint(s): 3 and 5 days, 1 month 4. Mortality; Timepoint(s): 6 and 12 months 5. New long-term residential care; Timepoint(s): 6 and 12 months 6. Quality of life; Timepoint(s): 6 and 12 months 7. Resource use; Timepoint(s): 6 and 12 months 8. Transfer to hospital; Timepoint(s): 6 and 12 months	—

Measure

Time frame

1. Activities of daily living; Timepoint(s): 6 and 12 months 2. Cognitive impairment; Timepoint(s): 6 and 12 months 3. Delirium; Timepoint(s): 3 and 5 days, 1 month 4. Mortality; Timepoint(s): 6 and 12 months 5. New long-term residential care; Timepoint(s): 6 and 12 months 6. Quality of life; Timepoint(s): 6 and 12 months 7. Resource use; Timepoint(s): 6 and 12 months 8. Transfer to hospital; Timepoint(s): 6 and 12 months

—

Countries

United Kingdom

Outcome results

None listed