The Impact of Frailty Screening of Older Adults With muLtidisciplinary Assessment of Those At Risk During Emergency Hospital Attendance on the Quality, Safety and Cost-effectiveness of Care (SOLAR): a Randomised Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 229
- 试验地点
- 2
- 主要终点
- Time to admission or discharge and if for admission, time that the bed is booked to go to medical wards.
研究概览
简要总结
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.
详细描述
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.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
盲法说明
The outcome assessor will be unaware if the participant was in control or intervention arm
入排标准
- 年龄范围
- 75 Years 至 —（Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •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
排除标准
- •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.
结局指标
主要结局
Time to admission or discharge and if for admission, time that the bed is booked to go to medical wards.
时间窗: 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)
时间窗: 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
次要结局
- Rate of Hospital Readmission(30 days and 6 months)
- Patient Satisfaction-(30 days)
- Rate of ED Representation(30 days and 6 months)
- Patient Quality of Life(30 days)
- Functional Decline(30 days and 6 months)
- Number of visits to family doctor, therapists or public health nurse(30 days and 6 months)
- Mortality(30 days and 6 months)