Compared Efficacy of Nurse-led and GP-led Geriatric Assessment in PrImary Care: A Pragmatic Three-arm Cluster Randomized Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 750
- 试验地点
- 2
- 主要终点
- Primary composite endpoint combined with: - Percentage of all-cause mortality - Percentage of Unplanned hospital admission - Percentage of Emergency visits. - Percentage of Institutionalization
研究概览
简要总结
Older patients account for around 10% of the population, of which 57% have a long-term illness, and 33% were admitted in the past year.
Geriatric assessment (GA) is a multidimensional assessment of general health status that can help identifying deficiencies and followed by a personalized care plan.
Assessment and management of elderly patients is a daily concern for the general practitioner (GP) but conflicting results have been reported so far relating to the clinical impact of GA when applied in the primary care setting.
This study protocol aims to assess the effect on morbi-mortality of a complex intervention in patients aged ≥70 years with chronic conditions in primary care. It aims to demonstrate that a GA adapted to primary care, followed by a personalized care plan and combined with successful interprofessional collaboration can improve clinically relevant outcomes in elderly patients with chronic conditions such as one-year overall mortality, unplanned hospital admission, emergency visits, or institutionalization.
The CEPIA study will also help addressing the issue of whether an improved benefit could be achieved from a systematic nurse-led or a case-by-case GP-led GA.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- None
入排标准
- 年龄范围
- 70 Years 至 —（Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients aged≥70 years with a long-term illness scheme or hospital admission the past 3 months
- •Visiting their preferred general practioner (GP) or another GP in the same practice
- •patient oral non opposition
排除标准
- •Patient who does not speak French
- •Severe disease with a life expectancy <12 months
- •Institutionalized patients
- •Patient insured under the French national health insurance system
结局指标
主要结局
Primary composite endpoint combined with: - Percentage of all-cause mortality - Percentage of Unplanned hospital admission - Percentage of Emergency visits. - Percentage of Institutionalization
时间窗: At 12 months
次要结局
- Percentage of all-cause mortality(At 12 months)
- Percentage of Emergency visits(At 12 months)
- Quality of life (Duke profile score)(At Day 0 and 12 months)
- Autonomy by KATZ ALD score(At Day 0 and 12 months)
- Percentage of geriatric phone advices requested by GPs(Up to 12 months)
- Percentage of health care actions planned(Up to 12 months)
- Percentage of Unplanned hospital admission(At 12 months)
- Percentage of Institutionalization(At 12 months)
- Percentage of Geriatric assessment performed(Up to 12 months)
- Percentage of personalized care plan performed(Up to 12 months)
- Satisfaction of general practitioners and nurses after completion of intervention(12 months after the beginning of the study)
- Number of medication prescription (polypharmacy)(Up to 12 months)
- Percentage of satisfied general practitioner with the intervention(27months after the beginning of the study)