Teleradiology Program for Frail Patients Living at Home or in Nursing-homes
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 162
- 主要终点
- Clinical impact of the activation of a teleradiology service for home care teams and nursing homes - number of participants with positive clinical impact as assessed by multidimensional assessment.
研究概览
简要总结
Transporting radiology to the patient's home is challenging. Preliminary experiences conducted in Turin (Italy) and Lund (Sweden) indicate that the coupling of simple, light-weight X-ray equipments with a Computed radiography or Digital Radiography systems could be effective for externalization of radiographic service.
The image and examination quality has been proved to be the same than those performed with a stationary equipment and analysis on safety of radio-protection systems show a very low risk exposure for health staff as well as for the general population.
Mobile radiography in nursing homes has shown to be technically feasible and the most beneficial results were that patients avoided unnecessary transport back and forth to the hospital; in both experiences the majority of patients could be treated locally.
The key points of RADHOME project are two:
- The first one is to built a network model, with the aim to disseminate clinical use of domiciliary radiology.
- The second one is to demonstrate clinical efficiency and cost-effectiveness of domiciliary radiology.
详细描述
Europe currently has the highest proportion of older people in the world and is expected to maintain this leading position for the next 50 years.
Population ageing is a great challenge for public health care systems as well as for economic development. As nations age, the prevalence of disability, frailty, and chronic diseases is expected to increase dramatically.
The hospital, which at the moment is the first choice for the delivery of acute medical care, is not an ideal environment for frail, elderly patients. New functional impairment and iatrogenic events such as nosocomial infections, pressure sores, falls and delirium, are common during hospital stay.
With developments in medical and other technologies, people with very complex conditions can increasingly have the possibility to remain at home or in nursing homes rather than in hospital.
Technologies can also improve the quality of life of patients and informal caregivers, allowing people to receive care and remain active at home and in the community, instead of being institutionalized.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Health Services Research
- 盲法
- Single (Participant)
入排标准
- 年龄范围
- 65 Years 至 —（Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •patients residents in nursing homes
- •patients cared at home by community care services
- •immobilization or chairbound
- •need for chest, pelvis/hips, joints, upper and lower limbs, hands and feet X-rays,
排除标准
- •need of urgent examination (within24 hours)
- •need of X-ray examinations not suitable at home/nursing home.
研究组 & 干预措施
CASI
Teleradiology service for patients residing at home or in nursing homes
干预措施: Teleradiology Service (Other)
CONTROLLI
X-ray hospital department
结局指标
主要结局
Clinical impact of the activation of a teleradiology service for home care teams and nursing homes - number of participants with positive clinical impact as assessed by multidimensional assessment.
时间窗: 4 years
All patients will be examinated using a standardized protocol which included multidimensional assessment. The multidimensional evaluation will be performed using standardized instruments: Activities of Daily Living (ADL) and Instrumental Activity of Daily Living (IADL) for functional status, Geriatric Depression Scale (GDS) for depression, Mini Mental State Examination (MMSE) for cognitive status, Cumulative Illness Rating Scale (CIRS) for comorbidity, Confusion Assessment Method (CAM) for delirium. A pain evaluation will be performed using the Visual Analogic Scale (VNS).
次要结局
- Organizational impact of the activation of a teleradiology service for home care teams and nursing homes - waiting time and organizational path.(4 years)
- Economic impact of the activation of a teleradiology service for home care teams and nursing homes - cost effectiveness analysis.(4 years)
- Number of participants with positive impact on life quality as assessed by Nottingham Health Profile (NHP) for quality of life.(4 years)
- Number of patients and care givers with high degree of satisfaction as assessed by Parasuraman Servqual methods.(4 years)
研究者
Vittoria Tibaldi
MD PhD
A.O.U. Città della Salute e della Scienza