An Intervention for Elderly in Emergency Services

NCT01706133 | Completed

• 1 other identifier: R-201 l-785-056
• Study Type: interventional
• Target: 1,400
• Locations: 1 country
• Sites: 1

Brief Summary

-Can a scheme based on inter geriatricians visiting nurse consultants and reduce negative impacts on the health of elderly over 70 years ?

Conditions

Stroke; Ischemic Attack; Diabetes Mellitus; Hypertension; Fragility

Keywords

Frailty, emergency services, elderly

Outcome Measures

Primary Outcomes (1)

• Change in hand grip strength (HS) as a physical performance test

  A standardized technique and digital dynamometers (Exacta TM) wil lbe used, and the best result of two tests in the dominant hand will be used for analysis. No cut-off points will be applied; instead the variable will be assessed as a continuous one with kilograms as the units of measure.

  Basal and Six months

Secondary Outcomes (1)

• Evaluation of individual and institutional impact

  Six Months

Other Outcomes (1)

• Quantify hospital readmissions

  One Year

Study Arms (1)

Basal phase

NO INTERVENTION

Integrated measurement of all variables involved impact and frequency of prior use of health services and specifically to the emergency room, service access, patient characteristics, features for the classification of frailty, cognitive impairment and depression, why consultation, triage scale level on admission to the service and to the service variables in terms of length of stay, diagnosis and medical management, and related services with internal consultants percentage of inpatients discharged or deceased, in further analysis the researchers undertake group estimating frequency of use and the identification of factors associated with the use of emergency departments and adverse events

Other: Factors associated with the use of emergency departments

Interventions

Factors associated with the use of emergency departments OTHER

Participants who were assigned to the intervention will be evaluated jointly by the medical service by a medical specialist in geriatrics and a nurse trained in gerontology and geriatrics. The doctor will monitor the apparition and / or aggravation of any geriatric syndromes already established by the specialty in geriatrics, namely, polypharmacy, delirium, dementia, depression, risk of falls, etc.. The nurse will monitor and follow up in four areas I. medical issues (pressure ulcers, infusion, mobility); II. Mental and emotional state and coping strategies with hospitalization; III. functionality, and IV. Atmosphere (A. Service status, architectural difficulties for mobility, bathing etc. B. Support Network, caregiver, and C. hardship)

Basal phase

Eligibility Criteria

• Age: 70 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)

You may qualify if:

• Adults 70 and over.
• Both sexes
• Affiliation force in the IMSS
• Attending spontaneously or referred to the emergency department of hospitals in the study.
• Agree to participate in the study phase in observational or intervention by signed written informed consent

You may not qualify if:

• Adults 70 and older whose income is service by:
• a. A very serious acute condition with imminent risk to life and requires immediate emergency care, cataloged by the Triage system marked by the IMSS as Red or (state the patient's functional impairment characterized by high and low, with imminent risk life or the integrity and function of some of their organs and requires immediate medical attention since his arrival to the emergency room) or require emergency care (patient condition characterized by acute and severe functional impairment, life-threatening or the integrity and function of some of their organs and requires medical attention within the next 10 minutes after arrival at the emergency department).
• An automobile accident
• Burn-grade II or III
• Partial or total unconsciousness
• Severe cognitive impairment
• Individuals who do not agree to participate in the study

Sponsors & Collaborators

• Coordinación de Investigación en Salud, Mexico: lead
• Instituto Mexicano del Seguro Social: collaborator

Study Sites (1)

XXI Century National Medical

Mexico City, Mexico City, 06725, Mexico

Location

MeSH Terms

Conditions

Stroke; Diabetes Mellitus; Hypertension; Frailty

Condition Hierarchy (Ancestors)

Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases; Glucose Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases; Endocrine System Diseases; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Carmen García-Peña, PhD

  Epidemiological Research Unit and Health Services. XXI Century National Medical Center

  PRINCIPAL INVESTIGATOR

• Sergio Sánchez García, PhD

  Epidemiological Research Unit and Health Services. XXI Century National Medical Center

  STUDY CHAIR

• Teresa Juarez Cedillo, PhD

  Epidemiological Research Unit and Health Services. XXI Century National Medical Center

  STUDY CHAIR

• Rogelio Moncada Tobias, Doctor

  Emergency Service. General Hospital Zone No.2

  STUDY CHAIR

• Nubia Franco Alvarez, Doctor

  Internal Medicine. General Hospital Zone No. 2

  STUDY CHAIR

• José García González, Master

  Department of Nephrology. Regional General Hospital No. 1

  STUDY CHAIR

• Ulises Pérez Zepeda, Master

  Institute of Geriatrics

  STUDY CHAIR

• Leslie Viridiana Robles Jiménez, Doctor

  National Institute of Psychiatry

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Head, Research Unit on Aging

Study Record Dates

• First Submitted: October 10, 2012
• First Posted: October 15, 2012
• Study Start: June 1, 2013
• Primary Completion: March 1, 2014
• Last Updated: February 4, 2015

Record last verified: 2015-02

Locations

ME (1)