A Personalised Approach Utilising the Frailty Index to Empower Consumers to Make Informed Decisions About Having a Colonoscopy to Avoid Low Value Care. A Prospective Randomized Controlled Trial.
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Gastrointestinal Diseases
- Sponsor
- Princess Alexandra Hospital, Brisbane, Australia
- Enrollment
- 200
- Locations
- 1
- Primary Endpoint
- Satisfaction with the respective outpatient service.
- Status
- Recruiting
- Last Updated
- 9 months ago
Overview
Brief Summary
Frailty is a common clinical syndrome in older adults that may carry an increased risk for poor health outcomes including falls, hospitalisation, and mortality. Having a colonoscopy can be associated with potential adverse outcomes in frail patients. At present, however, frailty is not routinely assessed in gastroenterological clinical practice. In a prospective randomised controlled study consenting patients over 65 years at the Princess Alexandra Hospital will receive either a) personalised (tailored) approach that includes assessment of frailty and structured information provided to the consumer or b) current standard practice in regards to having a surveillance colonoscopy to determine the effects on patient satisfaction and percentage of colonoscopies avoided.
Detailed Description
Frailty is a common clinical syndrome in older adults that may carry an increased risk for poor health outcomes including falls, hospitalisation, and mortality. Having a colonoscopy can be associated with potential adverse outcomes in frail patients. At present, however, frailty is not routinely assessed in gastroenterological clinical practice. In a prospective randomised controlled study consenting patients over 65 years at the Princess Alexandra Hospital will receive either a) personalised (tailored) approach that includes assessment of frailty and structured information provided to the consumer or b) current standard practice in regards to having a surveillance colonoscopy to determine the effects on patient satisfaction and percentage of colonoscopies avoided. It is expected that engagement with patients and clinicians in regards to frailty will address expectations and subsequently support the ability of patients/consumers and clinicians to make informed decisions that minimise risks and maximise benefits in regards to surveillance colonoscopies.
Investigators
Gerald Holtmann
Director of Gastroenterology & Hepatology
Princess Alexandra Hospital, Brisbane, Australia
Eligibility Criteria
Inclusion Criteria
- •Patients aged over 65 years of age
- •Ability to understand the study instructions and answering questionnaires
Exclusion Criteria
- •Inability to consent or participate in the assessments (e.g. frailty assessment) that are required as part of this project.
- •Lack of informed consent
Outcomes
Primary Outcomes
Satisfaction with the respective outpatient service.
Time Frame: Week 0
'Based only upon your recent experience when you received a consultation in relation to a potential future endoscopic test, how likely are you to recommend the respective health care organization (PAH or RWBH) to a friend, family member or colleague?.' Please rate your experience on a scale of 1 to 10, where 1 is extremely unlikely and 10 extremely likely.
Patient satisfaction questions
Time Frame: Week 0
Patients will be asked Overall, how would you rate the care you received? 1. Very good 2. Good 3. Adequate 4. Poor 5. Very poor Were you involved as much as you wanted to be in decisions about your care and treatment? 1. Yes, definitely 2. Yes, to some extent 3. No, not enough How much information about your condition or treatment was given to you? 1. The right amount 2. Too much 3. Not enough
Percentage of consumers in the intervention and control group that are referred for a surveillance colonoscopies who decide not have the procedure based upon the information provided.
Time Frame: Week 0-2 after consultation with doctor
• Percentage of consumers in the intervention and control group that are referred for a surveillance colonoscopies who decide not have the procedure based upon the information provided.
Comprehensive Endoscopy Satisfaction Tool
Time Frame: Week 2-4 After colonoscopy procedure
This captures the overall satisfaction with the service events (endoscopic procedure and relevant components including the pre-procedure assessment). Higher scores greater satisfaction
Secondary Outcomes
- Number of participants with non colorectal cancer related mortality information within 5 years of the referral(Non colorectal cancer related mortality information within 5 years of the referral)
- Number of participants with colorectal cancer related morbidity(Colorectal cancer related morbidity within 5 years of the referral)