Frail Elderly People
Conditions
Keywords
very frail, case manager, integrated care, multiprofessional, intervention
Brief summary
The present study Continuum of care for frail elderly people form part of the research programme Support for frail elderly persons - from prevention to palliation (www.vardalinstitutet.net) which comprises research into three interventions. The program comprises interventions addressing frail elderly people in different phases of the disablement process, from elderly people who are beginning to develop frailty to very frail elderly people receiving palliative care. The intervention Continuum of care for frail elderly people addresses elderly people who are frail and that have a great risk of high health care consumption. The hypothesis is that an intervention program for frail elderly people can reduce the number of visits to the emergency department, increase the life satisfaction and maintain the functional ability. The intervention, including an early geriatric assessment at the emergency department, early family support, a case manager in the community with a multi-professional team and active follow-up by the case manager, contributes to early recognition of the elderly people's need of information, care and rehabilitation and of informal caregivers' need of information. It enhances the transfer of information and integrates the care between different caregivers and different care levels, thereby better recognize frail elderly people's needs. Specifically, this study is expected to show that the intervention has a positive effect on the frail elderly person's functional ability, life satisfaction, satisfaction with health and social care, and health care consumption.
Interventions
OTHERintegrated health care chain
Geriatric assessment at ED, case manager with multiprofessional team in the community, support for informal caregivers
Sponsors
VinnVård
Vardalinstitutet The Swedish Institute for Health Sciences
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* 80 years and older or 65 to 79 years and having at least one chronic disease and being dependent in at least one activity of daily living
Exclusion criteria
* acute severely sick who immediately needs the assessment of a physician (within ten minutes) * those with diagnosis of dementia (or severe cognitive impairment) * patients in palliative care
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Health Care Consumption | 1 year | Number of hospital days and admission will be analysed |
| Dependence in Activities of Daily Living | 1 year | Changes in number of person dependent in one or more daily activity from baseline to follow-up. |
| Satisfaction With Health and Social Care | 1 year | — |
Countries
Sweden
Participant flow
Recruitment details
recrutment period October 2008 to July 2011
Pre-assignment details
exluded due to sheltered housing (n=2), dementia (n=1),palliative care (n=1) and died before baseline (n=4), declined particapation (n=12)
Participants by arm
| Arm | Count |
|---|---|
| Conventional Care, Controlgroup conventional care, control group | 76 |
| Integrated Health Care Chain integrated health care chain. Geriatric assessment at emergency department (ED), case manager with multiprofessional team in the community, support for informal caregivers
integrated health care chain : Geriatric assessment at ED, case manager with multiprofessional team in the community, support for informal caregivers | 85 |
| Total | 161 |
Baseline characteristics
| Characteristic | Integrated Health Care Chain | Conventional Care, Controlgroup | Total |
|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 85 Participants | 76 Participants | 161 Participants |
| Age, Categorical Between 18 and 65 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Continuous | 82.7 years STANDARD_DEVIATION 5.2 | 82.1 years STANDARD_DEVIATION 5.8 | 82.4 years STANDARD_DEVIATION 5.5 |
| Region of Enrollment Sweden | 85 participants | 76 participants | 161 participants |
| Sex: Female, Male Female | 47 Participants | 42 Participants | 89 Participants |
| Sex: Female, Male Male | 38 Participants | 34 Participants | 72 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 0 / 76 | 0 / 85 |
| serious Total, serious adverse events | 0 / 76 | 0 / 85 |
Outcome results
Primary
Dependence in Activities of Daily Living
Changes in number of person dependent in one or more daily activity from baseline to follow-up.
Time frame: 1 year
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Conventional Care, Controlgroup | Dependence in Activities of Daily Living | 18 participants |
| Integrated Health Care Chain | Dependence in Activities of Daily Living | 33 participants |
Primary
Health Care Consumption
Number of hospital days and admission will be analysed
Time frame: 1 year
Primary
Satisfaction With Health and Social Care
Time frame: 1 year