Multimorbid and Poly-treated Older People
Conditions
Brief summary
The main goal of thi clinical trial is to evaluate if a protected discharge model can reduce the length of hospital stay in older participants aged over 65 years old who have been admitted to the hospital for an acute event and have been considered stable and dischargeable. Participants of the intervention group will be asked to transfer to a small apartment, inside the hospital setting, equipped by technological devices and to be involved in cognitive and physical activities during the stay. Researchers will compare this intervention group with a control group who receive normal clinical practice where older people remain in the hospital ward.
Detailed description
Participants who fit the inclusion criteria are randomized in two arms (intervention or control groups). All of them are evaluated with a comprehensive geriatric assessment (Multidimensional Prognostic Index), a depression scale (Geriatric Depression Scale), quality of Life scale (Short-Form 12 items), and physical parameters (Hand Grip, Short Physical Performance Battery, gait speed). In the intervention group the following clinical parameters will be collected through technological devices: spontaneous physical performance, sleep monitoring, gait speed, quality of movements, heart rate, SpO2, and other vital parameters.
Interventions
DEVICEPRO-HOME intervention
Patients are transferred to the apartment inside the hospital setting and are evaluated and assessed also using technological devices
Sponsors
Alberto Pilotto
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Randomized clinical trial
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. participants aged 65 years or older; 2. admitted to the acute geriatric units for an acute event; 3. deemed stable and dischargeable from the hospital; 4. good personal autonomy in the Activities of Daily Living (ADL) (according to the Katz ADL scoring≥ 3/6); 5. normal cognition or mild cognitive impairment (Short Portable Mental Status Questionnaire (SPMSQ) ≤ 5/10); 6. signed informed consent
Exclusion criteria
1. participants aged less than 65 years old 2. not considerable stable and dischargeable 3. ADL \<3/6 4. SPMSQ \> 5/10 5. not signed informed consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Length of hospital stay | At 1 month after the baseline | Evaluate the efficacy of a protected discharge model in terms of length of hospital stay in multimorbid and poly-treated older subjects |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Negative clinical outcome: institutionalization | 1, 3 , 6 months after the baseline | Evaluate negative clinical outcome about institutionalization recording the access in institution related to each patient after the intervention, if relevant |
| Negative clinical outcome: mortality | 1, 3 , 6 months after the baseline | Evaluate negative clinical outcome about mortality collecting the data about mortality (date and reason of death) if relevant |
| Step mean through smartwatch | At baseline | Units of measure: number of steps |
| Heart rate through smartwatch | At baseline | Units of measure: bpm |
| Negative clinical outcome: re-hospitalization | 1, 3 , 6 months after the baseline | Evaluate negative clinical outcome about re-hospitalization recording the number of re-hospitalization (number of access in the hospital's wards and related reason) related to each patient after the intervention if relevant |
| Distance covered through smartwatch | At Baseline | Units of measure: cm |
| Gait speed through kinect Azure | At baseline | Units of measure:meters/second |
| Trunk/head oscillation (body sway /lean in) through kinect Azure | At baseline | Units of measure: degrees |
| Daily inactivity time through smartwatch | At baseline | Units of measure: percentage of time spent inactive |
Countries
Italy
Outcome results
None listed