Physiotherapy Led Community Intervention for Older Adults Discharged From the Emergency Department

Not Applicable

Completed

• Conditions: Old Age; Debility; Health Services for the Aged

• Registration Number: NCT04983602
• Lead Sponsor: University of Limerick

Brief Summary

ED PLUS Emergency Department Discharge Physiotherapy Led Community Service is a pilot feasibility randomized controlled trial investigating the role of an integrated care intervention consisting of comprehensive geriatrics assessment in older adults in the emergency department and a physiotherapy-led community based intervention.

Detailed Description

All patients who are aged 65 years and over will be screened using the Identification of Seniors at Risk (ISAR) Tool in the emergency department of a University Teaching Hospital. Those with a score of 2 or above in the ISAR and suitable for discharge home will be randomised. The first treatment arm will undergo geriatric medicine item directed Comprehensive Geriatric Assessment (CGA) from admission to emergency department (ED). The non-treatment arm will under usual patient care. The second treatment arm will undergo geriatric medicine team directed CGA from admission to ED and a physiotherapy led community based 6 week intervention in the patient's home. A dedicated multidisciplinary team of geriatric medicine trainee, occupational therapist, physiotherapist and medical social worker will carry out the assessment. For those randomised to the second treatment arm, a physiotherapist will assess and carry out a 6 week interventions that arise from that assessment and liaise with the patients General Practitioner (GP), medical social worker and other health care professionals. The overall aims of ED PLUS are assess the feasibility of the 6 week physiotherapy led intervention. Feasibility will be determined by the following outcomes:

i) Recruitment rate

ii) Adherence rate

iii) Acceptability of the programme

iv) Retention

v) Incidents

The secondary aims are to improve function, reduce anxiety and depression, improve quality of life and prevent unnecessary ED admission.

Study Timeline

• Study First Submitted: 2021-06-23
• Study First Submitted QC: 2021-07-21
• Study First Posted: 2021-07-30
• Study Start: 2021-09-13
• Primary Completion: 2022-06-13
• Study Completion: 2022-06-13
• Status Verified: 2022-07
• Last Update Submitted: 2022-07-26
• Last Update Posted: 2022-07-27

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 29

Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Functional Decline	6 months post ED visit	Barthel Index is global measure of functional status with a score from 0-20. A score of 0 is completely dependent, 20 is fully independent.

Secondary Outcome Measures

Name	Time	Method
Mortality	6 weeks post ED index visit or 6 months post ED index visit	A record of the patient having died within 6 weeks or 6 months
Patient Quality of Life	Baseline, 6 weeks post ED visit and 6 months post ED visit	Patient rated quality of life is determined by the Euro Quality of Life EQ5D. This scale is scored from 0 to 100 where 0 is the worst imaginable health state with 100 being the best imaginable.
Patient satisfaction	Baseline, 6 weeks post ED visit and 6 months post ED visit	Patient satisfaction is determined by the Patient Satisfaction Survey III Short Form (PSQ18). This is scored from 18 to 90, with 18 being the lowest level of satisfaction to 90 being the best score
Rate of ED representation	Baseline, 6 weeks post ED visit and 6 months post ED visit	A record of the patient coming back to the ED within 6 weeks and/or 6 months post ED index visit
Patient Experience Times	6 weeks	Exact time of admission or discharge form the ED will be collected at 6 weeks post ED index visit
Number of visits to the family doctor or public health nurse	6 weeks and 6 months post index ED visit	Determined by self reported visits to family doctor or public health nurse. This will be a telephone consultation at 6 week and 6 months post ED index visit where patients will be asked if they have visited a family doctor or public health nurse in the previous 6 weeks at the 6 week telephone call, or 6 months at the 6 month telephone call
Rate of Hospital readmission	Baseline,6 weeks post ED visit and 6 months post ED visit	A record of the patient requiring admission to the hospital within 6 weeks and/or 6 months

Trial Locations

Locations (1)

University Hospital Limerick; 🇮🇪 Limerick, Ireland