Anticipatory & Preventive Team Care (APTCare): At Risk Patients of Family Health Networks

NCT00238836 | Unknown Phase 2

• 1 other identifier: APTCare
• Study Type: interventional
• Target: 240
• Locations: 1 country
• Sites: 1

Brief Summary

The University of Ottawa and Élisabeth Bruyère Research Institute are conducting a study of preventive care for frail patients at risk of functional decline. At risk patients are assigned by chance to continue receiving their standard care from their family physician or receive additional care from a nurse practitioners and a pharmacist. In collaboration with the family physician, they develop an individualized care plan, a treatment and management road plan, for each patient, which they implement over the study period of one approximately year. The objective of the study is to compare the effectiveness of the model of care that includes the nurse practitioners and pharmacist against standard care in preventing functional decline, to determine the acceptability of this model of care to patients, their caregivers and the medical team, and to evaluate the cost implication of the program.

Conditions

Diabetes; Chronic Obstructive Pulmonary Disease; Congestive Heart Failure; Hypertension

Interventions

Self-management of chronic illness BEHAVIORAL

Eligibility Criteria

• Age: 50 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• years and over
• 'At Risk' by having one or more of the following: a. Visits to emergency dept within the past 6 months; b. Admission to hospital for a medical problem in past 6 months; c. High service use profiles; d. Polypharmacy; e. Other high risk factors
• Capable of giving informed consent
• Able to use the Care Companion technology

You may not qualify if:

• Cognitive impairment such that they cannot give informed consent
• Unable or unwilling to use the telehomecare equipment
• Unlikely to tolerate the intensive intervention
• Language or cultural barriers
• Being acutely ill or having an unstable condition on entry to the study

Sponsors & Collaborators

• C. T. Lamont Primary Care Research Centre: lead
• Ontario Ministry of Health and Long Term Care: collaborator
• University of Ottawa: collaborator

Study Sites (1)

West Carleton Family Health Network

Carp, Ontario, K0A 1L0, Canada

Location

Related Publications (4)

• Fletcher J, Hogg W, Farrell B, Woodend K, Dahrouge S, Lemelin J, Dalziel W. Effect of nurse practitioner and pharmacist counseling on inappropriate medication use in family practice. Can Fam Physician. 2012 Aug;58(8):862-8.

  PMID: 22893340 DERIVED

• Dahrouge S, Hogg W, Lemelin J, Liddy C, Legault F. Methods for a study of Anticipatory and Preventive multidisciplinary Team Care in a family practice. Can Fam Physician. 2010 Feb;56(2):e73-83.

  PMID: 20154234 DERIVED

• Gray D, Armstrong CD, Dahrouge S, Hogg W, Zhang W. Cost-effectiveness of Anticipatory and Preventive multidisciplinary Team Care for complex patients: evidence from a randomized controlled trial. Can Fam Physician. 2010 Jan;56(1):e20-9.

  PMID: 20090057 DERIVED

• Hogg W, Lemelin J, Dahrouge S, Liddy C, Armstrong CD, Legault F, Dalziel B, Zhang W. Randomized controlled trial of anticipatory and preventive multidisciplinary team care: for complex patients in a community-based primary care setting. Can Fam Physician. 2009 Dec;55(12):e76-85.

  PMID: 20008582 DERIVED

MeSH Terms

Conditions

Diabetes Mellitus; Pulmonary Disease, Chronic Obstructive; Heart Failure; Hypertension

Condition Hierarchy (Ancestors)

Glucose Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases; Endocrine System Diseases; Lung Diseases, Obstructive; Lung Diseases; Respiratory Tract Diseases; Chronic Disease; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Heart Diseases; Cardiovascular Diseases; Vascular Diseases

Study Officials

• William Hogg, MD

  C. T. Lamont Primary Care Research Centre

  PRINCIPAL INVESTIGATOR

• Jacques Lemelin, MD

  University of Ottawa

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER

Study Record Dates

• First Submitted: October 12, 2005
• First Posted: October 14, 2005
• Study Completion: March 1, 2006
• Last Updated: October 13, 2006

Record last verified: 2005-06

Locations

CA (1)