Improving Decision Making On Location of Care With the Frail Elderly and Their Caregivers

NCT02244359 | Completed

• 1 other identifier: CORE 2013-56
• Study Type: interventional
• Target: 455
• Locations: 1 country
• Sites: 1

Brief Summary

One of the toughest decisions faced by the frail elderly in Canada is whether to stay at home or move to a care facility. It is certainly difficult to make this decision alone, but can be even harder if someone else makes it for you. Shared decision making is when, instead of making decisions for the patient, healthcare professionals share information about what the evidence says, and they talk about what's important with the patient, and then make the decision together. In the case of the frail elderly in home care services, there are many health care professionals involved, e.g. the doctor, nurse and social worker. In this case decisions should be shared by all the professionals involved with the elderly person along with his or her caregivers. Unfortunately, in this context, shared decision making rarely occurs. We have designed a training program that teaches interprofessional teams how to share decisions with their frail elderly patients, and tested it in one Quebec City and one Edmonton home care team. This project tests the training program on a broader scale with 16 home care teams attached to community health centres across the province of Quebec, and will compare the results with what happens when no one has completed the training (usual care). Home care is a rapidly growing sector and this study will lay the foundations for a national strategy to ensure that no one has to make this difficult decision alone.

Conditions

Decision Process About the Location of Care Among Frail Elderly

Keywords

Shared Decision making; Patient Centred care; Interprofessionalism; Home care; Frail elderly

Outcome Measures

Primary Outcomes (1)

• The assumed role in the decision making process, and the preferred and chosen options.

  We will use the modified version of the Control Preferences Scale designed to assess the assumed role in the decision making process reported by the client.

  3 to 6 months

Study Arms (2)

Training

EXPERIMENTAL

Online tutorial, decision aid and interactive workshop

Behavioral: Training

Usual care

OTHER

Usual care

Behavioral: Usual care

Interventions

Training BEHAVIORAL

Training

Usual care BEHAVIORAL

Usual care

Eligibility Criteria

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

You may qualify if:

• Receiving care from the home care team
• Faced the decision about whether to stay at home or move to a care facility in the previous 3 to 6 months
• Able to read, understand and write french or english
• Able to give informed consent
• For the case of clients unable to provide informed consent, their caregivers who was involved into decision making process will be eligible

You may not qualify if:

• Clients who cannot provide informed consent (e. g. clients with cognitive impairment) without a caregiver
• Clients who require acute care hospitalization and whom the location of care decision is transferred to hospital-based social services

Sponsors & Collaborators

• CHU de Quebec-Universite Laval: lead
• TVN 2013 Core Research Grant Program: collaborator
• Ministere de la Sante et des Services Sociaux: collaborator
• Health and Social Services Agency, Montreal: collaborator

Study Sites (1)

CHU de Québec

Québec, Quebec, G1L 3L5, Canada

Location

Related Publications (5)

• Adekpedjou R, Haesebaert J, Stacey D, Briere N, Freitas A, Rivest LP, Legare F. Variations in factors associated with healthcare providers' intention to engage in interprofessional shared decision making in home care: results of two cross-sectional surveys. BMC Health Serv Res. 2020 Mar 12;20(1):203. doi: 10.1186/s12913-020-5064-3.

  PMID: 32164669 DERIVED

• Boucher A, Haesebaert J, Freitas A, Adekpedjou R, Landry M, Bourassa H, Stacey D, Croteau J, Genevieve PG, Legare F. Time to move? Factors associated with burden of care among informal caregivers of cognitively impaired older people facing housing decisions: secondary analysis of a cluster randomized trial. BMC Geriatr. 2019 Sep 9;19(1):249. doi: 10.1186/s12877-019-1249-1.

  PMID: 31500590 DERIVED

• Garvelink MM, Emond J, Menear M, Briere N, Freitas A, Boland L, Perez MMB, Blair L, Stacey D, Legare F. Development of a decision guide to support the elderly in decision making about location of care: an iterative, user-centered design. Res Involv Engagem. 2016 Jul 19;2:26. doi: 10.1186/s40900-016-0040-0. eCollection 2016.

  PMID: 29062524 DERIVED

• Garvelink MM, Freitas A, Menear M, Briere N, Stacey D, Legare F. In for a penny, in for a pound: the effect of pre-engaging healthcare organizations on their subsequent participation in trials. BMC Res Notes. 2015 Dec 8;8:751. doi: 10.1186/s13104-015-1743-2.

  PMID: 26645477 DERIVED

• Legare F, Briere N, Stacey D, Bourassa H, Desroches S, Dumont S, Fraser K, Freitas A, Rivest LP, Roy L. Improving Decision making On Location of Care with the frail Elderly and their caregivers (the DOLCE study): study protocol for a cluster randomized controlled trial. Trials. 2015 Feb 12;16:50. doi: 10.1186/s13063-015-0567-7.

  PMID: 25881122 DERIVED

Study Officials

• France Légaré, MD, PhD

  CHUQ Research Center

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: B. Sc. Arch, MD, PhD, CCMF, FCMF

Study Record Dates

• First Submitted: September 17, 2014
• First Posted: September 19, 2014
• Study Start: September 1, 2014
• Primary Completion: August 1, 2016
• Study Completion: August 1, 2016
• Last Updated: August 25, 2016

Record last verified: 2016-08

Locations

CA (1)