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Impact of Educational and Professional Supportive Interventions on Nursing Home Quality Indicators

Not Applicable
Completed
Conditions
Quality Indicators
Physical Disability
Interventions
Behavioral: Audit and Feedback
Behavioral: Cooperative Work
Registration Number
NCT01703689
Lead Sponsor
Agence Régionale de la Santé - Midi Pyrénées
Brief Summary

Introduction: Efficacy of audit and feedback interventions on nursing home (NH)quality indicators is not well-established.

The main objective: The main purpose of the IQUARE study was to examine the impact of two types of audit and feedback interventions on NH quality indicators and on residents dependence levels in a 18-month follow-up.

Study hypothesis: We hypothesised that audit and feedback associated to educational and professional supportive interventions are more efficacy in improving NH quality indicators than audit and feedback only.

Secondary objectives: Investigate the impact of the interventions on

1. Residents:

* Functional decline rate

* Drug prescriptions (quantity and quality)

* Prevalence of adverse health outcomes (e.g., falls)

2. NHs:

* Planning and implementation of therapeutic measures

Detailed Description

IQUARE is a multicentric individually-tailored controlled trial comparing two types of audit and feedback interventions:

* audit and feedback associated to cooperative work meetings between hospital geriatricians and nursing home (NH) staff in a 6-month intervention (strong intervention)

* audit and feedback only (light intervention) Power statistics and sample size calculations indicated that each group should be composed of at least 2 500 individuals. The strong intervention will last 6 months and is composed of two face-to-face cooperative meetings (hospital geriatricians and NH staff). Data will be collected at baseline and in a 18-month follow-up.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
8039
Inclusion Criteria
  • Nursing homes (NH) voluntarily accepted to participate in the study.
  • NH residents of both sex
  • Residents living in the NH for ≥ 30 days
  • Residents and their general practitioner (GP) having received information about the study
  • NH residents do not voluntarily decline to participate in the study
Exclusion Criteria
  • NH currently participating in another interventional study
  • GP of NH residents refused participation in the study.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
intervention group (LIG)Audit and FeedbackNursing homes that only received audit and feedback information on quality indicators
strong intervention group (SIG)Audit and FeedbackNursing homes that received audit and feedback information on quality indicators and benefited of cooperative work meetings with hospital geriatricians
strong intervention group (SIG)Cooperative WorkNursing homes that received audit and feedback information on quality indicators and benefited of cooperative work meetings with hospital geriatricians
Primary Outcome Measures
NameTimeMethod
Change from baseline in nursing home quality indicators at 18 monthsbaseline and 18-month follow-up

Indicators of quality of care in 10 main outcomes: dementia (e.g.,prevalence of cognitive assessment), behavioural disturbances (e.g., prevalence of behavioural disturbances assessment), restraining (e.g., prevalence of restrained residents with a medical prescription for restraining), mood (e.g., prevalence of mood assessment), osteoporosis and falls (e.g., systematic analysis of fall records), nutrition (e.g., prevalence of residents who were weighed ≥ 3 times in the last 3 months), pressure ulcers (e.g., prevalence of residents who were evaluated for the risk of pressure ulcers), pain (e.g., prevalence of residents who were evaluated for pain among residents in end-of-life), medication (e.g., prevalence of re-evaluation of residents' drug prescriptions among residents who take psychotropic), and care and services (e.g., prevalence of hospitalisations in the emergency department in the last 12 months).

Secondary Outcome Measures
NameTimeMethod
Onset of dependence in activities of daily living from baseline to 18 months follow-upbaseline and 18-month follow-up

Onset of dependence will be measured using the 6-item Katz ADL scale. Activities examined are: bathing, dressing, transferring, walking inside home, incontinence, and eating/drinking. Ability in executing each activity will be set as: "able to execute alone, without difficulty", "able to execute alone, with some difficulty", or "needing help to execute or unable to execute".

Trial Locations

Locations (174)

Castelgirou

🇫🇷

Cépet, France

EHPAD les arcades

🇫🇷

Dourgne, France

EHPAD le parc ALBI

🇫🇷

Albi, France

EHPAD Canarie Vieuzac

🇫🇷

Argelès-Gazost, France

MAPAD Les Pradels

🇫🇷

Assier, France

Les jardins d´Agape

🇫🇷

Auch, France

Les Jardins auscitains

🇫🇷

Auch, France

Saint Dominique

🇫🇷

Auch, France

ONAC résidence paul oddo

🇫🇷

Barbazan, France

EHPAD Résidence Castelmouly

🇫🇷

Bagnères-de-Bigorre, France

EHPAD Résidence Mutualiste La Pyrénéenne

🇫🇷

Aureilhan, France

Notre Dame

🇫🇷

Beaumont-de-Lomagne, France

Ehpad Sherpa

🇫🇷

Belmont-sur-Rance, France

Le Pastel

🇫🇷

Bessières, France

Le Pastourel

🇫🇷

Bessières, France

Emeraude

🇫🇷

Blagnac, France

Sainte-Cécile

🇫🇷

Bessières, France

Résidence de Vinci

🇫🇷

Blagnac, France

EHPAD St joseph de BRASSAC

🇫🇷

Brassac, France

EHPAD Robert Durrieu

🇫🇷

Bretenoux, France

M.R Orpea

🇫🇷

Cahors, France

EHPAD La Cascade

🇫🇷

Cajarc, France

EHPAD La Croix Bleue

🇫🇷

Capdenac-gare, France

EHPAD le bosc Carmaux

🇫🇷

Carmaux, France

Tour Tottier

🇫🇷

Castelginest, France

M.R St Luc - Castelnau Montratier

🇫🇷

Castelnau-Montratier, France

Chic Ehpad C.H

🇫🇷

Castelsarrasin, France

EHPAD Villégiale Saint Jacques CHIC - CASTRES/MAZAMET

🇫🇷

Castres, France

MAPA Résidence St Astier

🇫🇷

Catus, France

EHPAD Caylus - Val de Bonnette

🇫🇷

Caylus, France

Jeanne Penent

🇫🇷

Cazères, France

EHPAD Arc-En-Ciel

🇫🇷

Cazals, France

ALLIANCE

🇫🇷

Cologne, France

EHPAD St Laurent

🇫🇷

Cruejouls, France

EHPAD Saint-Philippe

🇫🇷

Ercé, France

EHPAD St JEAN CH de Gaillac

🇫🇷

Gaillac, France

EHPAD St ANDRE CH de Gaillac

🇫🇷

Gaillac, France

EHPAD Accueil du Frère Jean

🇫🇷

Galan, France

EHPAD La Baïse

🇫🇷

Galan, France

EHPAD Résidence Zélia

🇫🇷

Ibos, France

EHPAD Le Jonquère

🇫🇷

Juillan, France

Ehpad Les Quietudes

🇫🇷

Lautrec, France

Ch Gimont

🇫🇷

Gimont, France

MR Charles de Gaulle

🇫🇷

Gramat, France

Saint-Jacques

🇫🇷

L´ Isle-Jourdain, France

Foyer Pierre Bonhomme

🇫🇷

Gramat, France

EHPAD Saint Dominique

🇫🇷

Gramond, France

Ehpad de Graulhet

🇫🇷

Graulhet, France

Ste Sophie

🇫🇷

Grisolles, France

EHPAD Gustave Pédoya

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La Bastide-de-Sérou, France

EHPADL'Oustal d'En Thibaud

🇫🇷

Labruguière, France

M.R La Miséricorde

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Lacapelle-Marival, France

Centre hospitalier du Pays d´Olmes - Laroques d´Olmes

🇫🇷

Laroques d´Olmes, France

Résidence du Lac

🇫🇷

Lafrançaise, France

La Barbacane

🇫🇷

Larrazet, France

MAPAD Les Ségalines

🇫🇷

Latronquière, France

Résidence Paul et Lisa

🇫🇷

Launaguet, France

EHPAD La Madone

🇫🇷

Lourdes, France

La Vendinelle

🇫🇷

Le Cabanial, France

Centre hospitalier du Pays d´Olmes - Résidence du Touyre

🇫🇷

Lavelanet, France

Ehpad Barrere

🇫🇷

Lectoure, France

Ehpad Feral

🇫🇷

Lectoure, France

EHPAD L´Oasis

🇫🇷

Livinhac-le-Haut, France

EHPAD Le Petit Jer

🇫🇷

Lourdes, France

EHPAD Notre Dame des Grâces

🇫🇷

Lugan, France

EHPAD Le Paginet

🇫🇷

Lunac, France

EHPAD Le santoulis

🇫🇷

Luzenac, France

Résidence Curtis

🇫🇷

Léguevin, France

EHPAD Faux-Bourg Saint-Adrien

🇫🇷

L´ Isle-en-Dodon, France

Val de Gers

🇫🇷

Masseube, France

EHPAD Le Clos du Raunier

🇫🇷

Mazères, France

EHPAD du CH Millau - St Michel

🇫🇷

Millau, France

EHPAD Les Charmettes

🇫🇷

Millau, France

MR Beau Séjour

🇫🇷

Mercuès, France

EHPAD de MONESTIES

🇫🇷

Monestiés, France

EHPAD Louise de Roquelaure

🇫🇷

Mirepoix, France

St Jean Marie Vianney

🇫🇷

Montbeton, France

Montauban - Ehpad Ushpa

🇫🇷

Montauban, France

Ange Gardien

🇫🇷

Montauban, France

MR Saint Orens

🇫🇷

Montauban, France

M.R La Roseraie

🇫🇷

Montfaucon, France

MR Sainte-Marie

🇫🇷

Montcuq, France

MR L´Etoile du Soir

🇫🇷

Montredon, France

L´Hermitage

🇫🇷

Montréjeau, France

EHPAD Rés. Parc de la Corette

🇫🇷

Mur-de-Barrez, France

Résidence Marie-Antoinette

🇫🇷

Muret, France

Le Barry

🇫🇷

Muret, France

EHPAD Sainte Marie les Ursulines

🇫🇷

Nant, France

EHPAD Résidence les deux vallées

🇫🇷

Nant, France

EHPAD Résidence du Lac

🇫🇷

Orleix, France

Centre Alzheimer Marie-Louise

🇫🇷

Pechbonnieu, France

La Houlette

🇫🇷

Pibrac, France

Cité Saint Joseph

🇫🇷

Plaisance du Gers, France

EHPAD La résidence du Lac

🇫🇷

Pont de Salars, France

La Tranquilité

🇫🇷

Pins-Justaret, France

Le Prat

🇫🇷

Plaisance-du-Touch, France

Oasis-Palmeraie

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Pointis-de-Rivière, France

L´Auta

🇫🇷

Portet-sur-Garonne, France

M.R Les balcons du Lot

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Prayssac, France

EHPAD Résidence du petit bois

🇫🇷

Pradines, France

Résidence Isatis

🇫🇷

Quint-Fonsegrives, France

EHPAD la Maison Du Lac

🇫🇷

Puygouzon, France

EHPAD Jean Baptiste Delfau

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Requista, France

M.R Les Lavandes

🇫🇷

Puy-l´Évêque, France

Bel Adour

🇫🇷

Riscle, France

EHPAD Les Rosiers

🇫🇷

Rignac, France

EHPAD Hermitage et Terrasses de Rabastens

🇫🇷

Rabastens, France

EHPAD de Revel

🇫🇷

Revel, France

EHPAD Bon Accueil

🇫🇷

Rodez, France

EHPAD Saint Cyrice

🇫🇷

Rodez, France

EHPAD La Miséricorde

🇫🇷

Saint-Affrique, France

Les Clos des Amandiers

🇫🇷

Saint-Alban, France

EHPAD Julie Chauchard

🇫🇷

Rodez, France

EHPAD Saint Jacques du CH

🇫🇷

Rodez, France

EHPAD Le clos de Siloe

🇫🇷

Roquecourbe, France

Lavallée

🇫🇷

Saint-Clar, France

EHPAD de l´Hôpital local

🇫🇷

Saint-Geniez-d´Olt, France

EHPAD Les Galets d´Olt

🇫🇷

Saint-Côme-d´Olt, France

Le Mas Saint-Pierre

🇫🇷

Saint-Gaudens, France

EHPAD Le Val d´Olt

🇫🇷

Saint-Laurent-d´Olt, France

L´Ensoleillade

🇫🇷

Saint-Gaudens, France

Centre hospitalier Ariège Couserans

🇫🇷

Saint-Girons, France

EHPAD Hector d´Ossun

🇫🇷

Saint-Lizier, France

Les Rossignols

🇫🇷

Saint-Lys, France

Maréchal Leclerc

🇫🇷

Saint-Lys, France

Résidence La Joie de Vivre

🇫🇷

Saint-Lys, France

EHPAD Clos St François

🇫🇷

Saint-Sernin-sur-Rance, France

Ehpad Chez Nous

🇫🇷

Saint-Sulpice, France

EHPAD Petite Plaisance SAVAGNAC

🇫🇷

Salvagnac, France

EHPAD Vert Coteau

🇫🇷

Saverdun, France

EHPAD Les grands chênes

🇫🇷

Saïx, France

EHPAD Paul Ané

🇫🇷

Seix, France

La Septfontoise

🇫🇷

Septfonds, France

Ehpad Le Pre Fleuri

🇫🇷

Serviès, France

EHPAD St Vinçent et Ste Croix

🇫🇷

Sorèze, France

EHPAD Sainte Marie

🇫🇷

Siradan, France

Les Tourelles

🇫🇷

Toulouse, France

EHPAD St Jean

🇫🇷

St AMANS DES COTS, France

Maurice Garrigou

🇫🇷

Toulouse, France

Résidence Saint-Simon

🇫🇷

Toulouse, France

La Cotonnière

🇫🇷

Toulouse, France

EHPAD Les Fontaines

🇫🇷

Toulouse, France

La Pastellière

🇫🇷

Toulouse, France

Orpéa Crampel

🇫🇷

Toulouse, France

Ehpad Belcantou

🇫🇷

Trébas, France

EHPAD Résidence Les Rives du Pélam

🇫🇷

Trie-sur-Baïse, France

Le Grand Marquisat

🇫🇷

Tournefeuille, France

EHPAD du Centre Hospitalier Des Deux Rives

🇫🇷

Valence D Agen, France

M.R Résidence Valpré

🇫🇷

Vayrac, France

EHPAD ND de Touscayrats

🇫🇷

Verdalle, France

MR Saint Jacques

🇫🇷

Verdun-sur-Garonne, France

EHPAD La Clairière - Les Acacias

🇫🇷

Vic-en-Bigorre, France

Ch Vic-Fezensac

🇫🇷

Vic-fezensac, France

Le Château fleuri

🇫🇷

Vic-Fezensac, France

EHPAD Sainte Claire

🇫🇷

Villefranche-de-Rouergue, France

Saint-Joseph

🇫🇷

Fronton, France

Caroline Baron

🇫🇷

Toulouse, France

La Cerisaie

🇫🇷

Castelmaurou, France

Korian Les Ainés du Lauragais

🇫🇷

Baziège, France

Les Roses

🇫🇷

Calmont, France

EHPAD Gai Logis

🇫🇷

Capdenac-Gare, France

Notre Dame du Bon Accueil

🇫🇷

Castelnau-d´Estrétefonds, France

MR Louis Conte

🇫🇷

Gramat, France

EHPADRouanet-Iché de LABASTIDE-ROUAIROUX

🇫🇷

Labastide-Rouairoux, France

EHPAD St vinçent de paul

🇫🇷

Lacaune, France

EHPAD résidence le grand champ

🇫🇷

Lagrave, France

Les Causeries

🇫🇷

Laguépie, France

MAPAD Les logis de l´Impernal

🇫🇷

Luzech, France

EHPAD Saint Joseph

🇫🇷

Marcillac-Vallon, France

Résidence de l´abbaye

🇫🇷

Saint-Antonin-Noble-Val, France

Plénitude Saint-Michel

🇫🇷

Toulouse, France

Arc-en-Ciel

🇫🇷

Toulouse, France

EHPAD Sud Rulhedu CH

🇫🇷

Villefranche-de-Rouergue, France

Le Pin

🇫🇷

Villeneuve-Tolosane, France

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