Hospital at Home care for elderly patients with cognitive impairment presenting on the emergency department with acute somatic illness and an indication for hospital admission: a randomized feasibility trial
- Conditions
- 100040181000984110001474Dementiadelirium
- Registration Number
- NL-OMON43141
- Lead Sponsor
- niversitair Medisch Centrum Groningen
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Completed
- Sex
- Not specified
- Target Recruitment
- 143
> Age >= 65yr > Established dementia, delirium or other cause of cognitive impairment present Previously diagnosed or; Confirmed with the IQCODE-sf (family) or in a patient by the 4AT-test31 and/or Short Blessed Test on the ED > Presentation with a defined acute illness > Felt to require hospital admission by attending ED physician, but not expected to require emergency interventions MEWS <= 2 / VIEWS < 7 > Living in hospital catchment area > Ambulatory ability 24hrs prior to ED presentation > Informal caregiver present, able to understand and perform instructions > Appropriate home circumstances (running water, adequate heating, safety)
- Need for medium or intensive care, based on MEWS-score and clinician judgment > Cut-off value emergency scores: MEWS >=3 / VIEWS >7 - Need for surgical assessment - Hospitalized within 7 days preceding ED presentation - Nursing home residents or awaiting a nursing home place on an active waiting list (excluding so called sleeping waiting list candidates) - Suspected acute coronary syndrome or cardiac arrythmia - Dialysis dependent patients - Expected terminal events or in need of palliative care due to oncological illness - Acute illness requiring hospital admission independent of the target diagnosis of presentation
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method <p>The main study parameters are the participation rate of the H@H trial among<br /><br>patients 65 years and older with cognitive impairment at the ED and the reasons<br /><br>for non-participation. </p><br>
- Secondary Outcome Measures
Name Time Method <p>Furthermore the different steps in the H@H care process will be timed and<br /><br>evaluated and if the quality of H@H care differs from usual hospital care will<br /><br>be studied. In addition we investigate advantages and disadvantages of H@H care<br /><br>and usual hospital care with regards to: time spent at home, number of<br /><br>transfers needed, number of health care professionals involved, (medical)<br /><br>equipment needed, functional status (ADL), health status, (health related)<br /><br>quality of life and costs.</p><br>