Use of Telemedicine for Geriatric Emergency Patients
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 50
- 试验地点
- 1
- 主要终点
- Differences in pharmacological interventions
研究概览
简要总结
The aim of the present study is the implementation of a telemedical geriatric co-evaluation in the area of the emergency department. The use of telemedicine is intended to improve the care of geriatric emergency patients.
Primarily, it should be checked whether there is any difference at all compared to the normal standard treatment by the doctors of the emergency department. For this, the different drug recommendations are compared.
For the qualitative evaluation, the second step is an analysis of the recommended drugs with regard to the use of inadequate preparations for older patients.
详细描述
Despite the changed age structure with a steady increase in life expectancy, doctors with geriatric expertise are lacking in many hospitals. In the "Rheinisch-Westfälische Technische Hochschule" (RWTH) Aachen University Hospital there is also the problem that the Department of Geriatrics is outsourced and therefore geriatric expertise is not always available in the emergency department. One way to solve this problem is to use telemedicine.
The aim of the present study is the implementation of a telemedical geriatric co-evaluation in the emergency department.
For the study it is planned to carry out a geriatric co-evaluation of geriatric emergency patients (age ≥ 70 years, "Identification of Seniors at Risk" [ISAR] -Score ≥ 2) with operative or conservative illnesses via a telemedical visit in the acute setting of the emergency department. There is a presentation of the patient by means of video transmission. The geriatrician then has the opportunity to question the patient independently or to carry out a physical assessment. Since there is no geriatrician at the Department of Geriatrics 24 hours a day, patients are included on weekdays between 8am and 5pm only.
Whenever possible, all patients in the emergency department at this time with an age ≥ 70 years and an ISAR score ≥ 2 will be enrolled at set times of the day. Due to the high number of patients in the emergency room, however, it may not be possible at times to include all patients. In order to ensure sufficient neutrality, in this constellation, the selection is made from the patients currently in the emergency room by means of randomization. Should there be age-related difficulties in communicating between patients and geriatrician during the telemedical visit, the present scientific assistant or doctor from the emergency department will assist to avoid an associated influence on the procedure.
The rationale behind the telemedicine visit is that this additional early geriatric co-assessment will result in improved geriatric follow-up beyond geriatric special care. In this pilot study, which aims at an analysis of the actual state with identification of potential problem areas, the focus is primarily on pharmacotherapeutic aspects.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 70 Years 至 —（Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age ≥ 70 years
- •Written declaration of consent
- •Indication for geriatric treatment according to "Identification of Seniors at risk" (ISAR) score screening with scores ≥ 2
- •Persons who are capable and mentally able to follow the instructions of the study staff
- •Legally incompetent persons with a consensual legal guardian or a person authorized by the patient to manage their affairs
排除标准
- •Persons who are accommodated on an official or court order in an institution
- •Persons who are in a dependency or employment relationship with the sponsor or examiner
- •Simultaneous participation in another clinical trial
- •Missing written consent
结局指标
主要结局
Differences in pharmacological interventions
时间窗: within 48 hours of admission to the emergency department
The primary endpoint is an evaluation of the different pharmaceutical interventions between the standard emergency department treatment and the telemedicine geriatric treatment. Number of different views per patient in the pharmacological differential therapy with regard to: * drug replacement * withdrawal of a pre-existing drug * dose adjustment of a pre-existing drug are being analyzed.
次要结局
- Quality of pharmacological interventions(within 48 hours of admission to the emergency department)
- Avoidance of Polypharmacy as a quality feature for age-appropriate therapy(within 48 hours of admission to the emergency department)
研究者
Dr. Oliver Matz
Consultant
RWTH Aachen University