SOLAR- Frailty Screening and Multidisciplinary Assessment of Older Adults in the Emergency Department
- Conditions
- Frailty
- Interventions
- Other: SOLAR
- Registration Number
- NCT04629690
- Lead Sponsor
- University of Limerick
- Brief Summary
SOLAR is a randomised control trial exploring the role of Comprehensive Geriatric Assessment (CGA) in older adults who screen positive for frailty based on the Identification of Seniors at Risk (ISAR) tool the the Emergency Department and Acute Medical Assessment Unit of a University Teaching Hospital.
- Detailed Description
All patients who are over seventy-five will be screened for frailty using the widely used ISAR tool. Those with a score of 2 or above in the ISAR will be randomised. The treatment arm will undergo geriatric medicine team-directed CGA from admission to Emergency Department (ED) or Acute Medical Assessment Unit (AMAU) whereby the non-treatment arm will undergo usual patient care. A dedicated multidisciplinary team of a geriatric medicine trainee, physiotherapist, occupational therapist and medical social worker will carry out the assessment, as well as interventions that arise from that assessment. Primary outcomes will be time from triage to decision to admit or discharge. Secondary Outcomes will be subsequent Emergency Department reattendance, rehospitalisation, functional decline and mortality at 30 days and 180 days. This will be recorded by telephone consultation and electronic records.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 229
- Older adults aged 75 years or over
- Medically stable as deemed by the treating physician
- A score of 2 or above on the ISAR
- Present with a medical complaint
- Those under the age of 75 years
- A score of less than 2 on the ISAR
- Acute myocardial infarction, stroke or non-medical problems e.g. surgical or psychiatric issues
- Patients who are medically unstable
- If neither the patient nor carer can communicate in English sufficiently to complete consent or baseline assessment
- Confirmed or highly suspicious of symptoms for COVID 19.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description SOLAR arm SOLAR The SOLAR arm will obtain a comprehensive geriatric assessment which will be provided by a geriatric doctor, physiotherapist, occupational therapist, social worker, pharmacist and specialist nurse.
- Primary Outcome Measures
Name Time Method Time to admission or discharge and if for admission, time that the bed is booked to go to medical wards. Exact time of admission or discharge from ED will be collected at 30 days from index visit This is the time that the patient is either discharged or identified for admission and bed booked to go to the medical wards
Patient Experience Times (PET) Exact time of admission or discharge from ED will be collected at 30 days from index visit PET time recorded as time of arrival at the ED to discharge or admission
- Secondary Outcome Measures
Name Time Method Rate of Hospital Readmission 30 days and 6 months A record of the patient requiring admission to the hospital within 30 days or 6 months
Patient Satisfaction- 30 days As determined by the Patient Satisfaction Survey III Short Form (PSQ18). This is scored from 18 to 90. 18 being the worst score and 90 being the best score.
Rate of ED Representation 30 days and 6 months A record of the patient coming back to the ED within 30 days and/or 6 months
Patient Quality of Life 30 days As determined by the Euro Quality of Life (Qol) EQ5D. Scored from 0 to 100. 0 is worst imaginable health state with 100 being the best imaginable health state
Functional Decline 30 days and 6 months As determined by the Barthel Index. Barthel Index is a score from 0-20. A score of 0 is completely dependent, 20 is fully independent.
Number of visits to family doctor, therapists or public health nurse 30 days and 6 months Determined by self reported visits to family doctor, allied health services or Public Health Nurse. There will be a telephone consultation at 30 days and 6 months where patients will be asked if they have visited a family doctor, therapist or public health nurse in the previous 30 days at the 30 day telephone call, or 6 months at the 6 month phone call.
Mortality 30 days and 6 months A record of the patient having died within 30 days or 6 months
Trial Locations
- Locations (1)
University Hospital Limerick
🇮🇪Limerick, Ireland