Ignite Creation Date:
2024-05-06 @ 8:24 PM
Last Modification Date:
2024-10-26 @ 3:27 PM
Study NCT ID:
NCT06368674
Status:
NOT_YET_RECRUITING
Last Update Posted:
2024-04-22
First Post:
2024-04-11
Brief Title:
Bridging the Gap Creating a Continuum of Care
Sponsor:
Göteborg University
Organization:
Göteborg University
Study Overview
Official Title:
Bridging the Gap Creating a Continuum of Care Through Active Follow-up by a Case Manager After Discharge - a Controlled Study
Status:
NOT_YET_RECRUITING
Status Verified Date:
2024-04
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
Coordination and integration between care settings is essential for the quality of care of frail older patients An active follow-up by a case manager CM after discharge form an acute geriatric hospital ward has the potential to bridge the gap between hospital primary and municipality care for frail older people This study evaluates the effects of an active follow-up by a CM in primary care after discharge from a geriatric ward with the following research questions Can an active follow-up by CM for frail older people discharged from an acute geriatric ward compared to those not receiving active follow up Maintainincrease independence in activities of daily living self-rated health and life satisfaction Increase satisfaction with health care Reduce health care consumptionbe cost-effective How feasible is the intervention and the study design from the perspective of the caregivers and the older person This is a clinical controlled study with a process evaluation Inclusion criteria are 75 years or older frail and admitted to a geriatric ward
This study is relevant since todays highly specialized acute care is poorly adapted to the comprehensive needs of frail older people and exposes them to avoidable risks such as loss of functional capacities causing unnecessary care needs and decreased wellbeing Active follow-up by a CM after discharge may be an important way to integrate the care for frail older people after receiving in-hospital geriatric care This can improve the quality of care for this vulnerable group and direct the right health care actions towards those in most need
The intervention is a active follow-up after discharge by a CM nurse in primary care CM will secure that discharge and care plans are executed and to address new needs If there are unmet needs the CM will ensure that adequate actions are performed to meet the needs The intervention group consists of participants discharged to a primary health care centre with a CM who actively follows-up after discharge The control group consists of participants discharged to a primary health care centre without CM and thereby no active follow-up after discharge All participants will be followed-up by the research team during one year concerning dependence in activities of daily living self-rated health health care consumption and satisfaction with care
This study is relevant since todays highly specialized acute care is poorly adapted to the comprehensive needs of frail older people and exposes them to avoidable risks such as loss of functional capacities causing unnecessary care needs and decreased wellbeing Active follow-up by a CM after discharge may be an important way to integrate the care for frail older people after receiving in-hospital geriatric care This can improve the quality of care for this vulnerable group and direct the right health care actions towards those in most need
The intervention is a active follow-up after discharge by a CM nurse in primary care CM will secure that discharge and care plans are executed and to address new needs If there are unmet needs the CM will ensure that adequate actions are performed to meet the needs The intervention group consists of participants discharged to a primary health care centre with a CM who actively follows-up after discharge The control group consists of participants discharged to a primary health care centre without CM and thereby no active follow-up after discharge All participants will be followed-up by the research team during one year concerning dependence in activities of daily living self-rated health health care consumption and satisfaction with care
Detailed Description:
None
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None