Impact of Either Audit and Feedback Only or Audit and Feedback Associated to Cooperative Work Meetings Between Hospital Geriatricians and Nursing Home Staff on Quality Indicators and Health Care Practices in Nursing Homes.
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Enrollment
- 8,039
- Locations
- 175
- Primary Endpoint
- Change from baseline in nursing home quality indicators at 18 months
Study Overview
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
- Residents:
- Functional decline rate
- Drug prescriptions (quantity and quality)
- Prevalence of adverse health outcomes (e.g., falls)
- 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.
Study Design
- Study Type
- Interventional
- Allocation
- Non Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Health Services Research
- Masking
- Single (Outcomes Assessor)
Eligibility Criteria
- Sex
- All
- Accepts Healthy Volunteers
- No
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.
Arms & Interventions
strong intervention group (SIG)
Nursing homes that received audit and feedback information on quality indicators and benefited of cooperative work meetings with hospital geriatricians
Intervention: Audit and Feedback (Behavioral)
strong intervention group (SIG)
Nursing homes that received audit and feedback information on quality indicators and benefited of cooperative work meetings with hospital geriatricians
Intervention: Cooperative Work (Behavioral)
intervention group (LIG)
Nursing homes that only received audit and feedback information on quality indicators
Intervention: Audit and Feedback (Behavioral)
Outcomes
Primary Outcomes
Change from baseline in nursing home quality indicators at 18 months
Time Frame: baseline 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 Outcomes
- Onset of dependence in activities of daily living from baseline to 18 months follow-up(baseline and 18-month follow-up)
Investigators
Yves Rolland
MD PhD
University Hospital, Toulouse