Effectiveness of a nurse-led case management home care model in primary health care: A quasi-experimental, controlled, multi-centre study

Completed

Conditions: ong term home care.
Not Applicable
N/A

Registration Number: ISRCTN44054549

Lead Sponsor: Ministry of Health (Spain)

Brief Summary: Not available

Detailed Description: Not available

Recruitment & Eligibility

Status: Completed

Sex: All

Target Recruitment: 286

Inclusion Criteria

Patients and caregivers initiating the Home Care (HC) programme launched by the Andalusian Healthcare Service and targeting some of the following population sub-groups:
Sub-group 1: Terminally ill patients with advanced stage, progressive, incurable, multi-symptomatic disease with no reasonable chance of responding to specific treatment, with estimated survival not exceeding six months
Sub-group 2: Dependent patients who require assistance for their daily activities (Activities of Daily Living [ADL]) and are immobilised at home, namely subjects not included in Sub-group 1 who, for whatever cause, are forced to spend most of their time in bed and/or require help to move, which prevents them from leaving home, except for rare exceptions
Sub-group 3: Patients not included in Sub-groups 1 and 2, recently discharged from hospital, requiring home care during a short period of time, most likely for under two months
Sub-group 4: Main caregivers for any of the patients described in the previous sub-groups

Exclusion Criteria

1. Institutionalisation or change of residence to an area not covered by the study, thus preventing the minimum follow-up required
2. Hospitalisation for longer than seven days, except for terminally ill patients who were readmitted for disease stabilisation and symptom control

Note: With these criteria in mind, the population potentially requiring home care services in the healthcare districts under the scope of the study was estimated at 1,032,333. Malaga with 50.93% of the total potential population was in a position to contribute the largest number of subjects to the study, followed by the Costa del Sol district with 20.46%, Almeria with 20.60% and lastly Granada with 8.55%.

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
1. Patient's functional capacity (Barthel and Lawton-Brody scales) at 0, 2, 6 and 12 months <br>2. Satisfaction (SATISFAD, specific questionnaire validated for assessment of satisfaction with home care services) at 2, 6 and 12 months <br>3. Hospital admissions <br>4. Accident & Emergency (A&E) visits <br>5. Home visits by nurses <br>6. Social worker interventions <br>7. Physiotherapy sessions <br>8. Caregiver visits to healthcare centre <br>9. Patient visits to healthcare centre

Secondary Outcome Measures

Name	Time	Method
1. Caregiver burden (Zarit test) at 0, 2, 6 and 12 months<br>2. Family role/function (APGAR family test) at 0, 2, 6 and 12 months<br>3. Cognitive function (Pfeiffer test) at 0, 2, 6 and 12 months <br>4. Quality of life (Euro-QoL 5D) at 0, 2 and 6 months <br>5. Institutionalisation<br>6. Mortality<br>7. Management of therapeutic regimen