Preventing Avoidable Admissions Among Assisted Living Elders

NCT02879396 | Completed

• 1 other identifier: 1608799126
• Study Type: interventional
• Target: 10
• Locations: 1 country
• Sites: 1

Brief Summary

Saint Luke Home (SLH) is a home for low-income seniors who are ≥ 55 years and in need of basic living help in Tucson, Arizona. Reports shows that emergency calls are made from SLH (64 residents) around 60 times each year with emergency department (ED) visits and hospital admissions that follow. In 2014, a total of 70 calls were made, and in 2015, 49 calls. The Director, who is a nurse by training, and staff report that many of these calls are related to medications and may be avoidable. Therefore, we believe we can make a difference and decrease emergency calls, ED visits and hospitalizations that can be avoided with a program to teach the elders and staff at SLH. The program is called Preventing Avoidable Admissions Among Assisted Living Elders (PA4LE) and will consist of a 2-hour session every two weeks including home or clinic visits (elder preference), educational sessions, and staff training.

Conditions

Aging; Emergencies

Keywords

Older adults; Avoidable admissions; Assisted living home; Emergency service calls; Heading Assisted Living Facilities

Outcome Measures

Primary Outcomes (1)

• EMS calls

  Reduce the number of EMS calls from avoidable causes by high-utilizers (≥ 4 calls) by 50%

  12 months

Secondary Outcomes (2)

• ED visits

  12 months

• Beers criteria medications

  12 months

Study Arms (1)

Study Participants

EXPERIMENTAL

A maximum of 50 participants will be enrolled in the study per the inclusion and exclusion criteria. The participants will be residents of SLH who are 55 years old or older. They will have had one or more EMS calls made, ED visit or hospital admission in the past year, as determined by the incidence report at SLH. The study participants will receive PA4LE program.

Behavioral: PA4LE Program

Interventions

PA4LE Program BEHAVIORAL

1. Medication self-management including medication reconciliation, therapy recommendations, and education by pharmacist (chronic conditions and medications including Beers Criteria) 2. Use of a patient-centered health record that helps guide patients through the care process (portable, health and medication record for elders) 3. Primary care provider and specialist follow-up (patient awareness of discharge action plan and follow-up) 4. Patient understanding of "red flag" indicators of worsening condition and appropriate next steps 5. Behavioral interventions - Adherence, Lifestyle modifications, Mindfulness \& Lovingkindness meditations to combat anxiety, insomnia and other behavioral symptoms

Study Participants

Eligibility Criteria

• Age: 55 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• One or more EMS calls made, ED visit or hospital admission in the past year, as determined by the incidence report at SLH

You may not qualify if:

• A score of ≤ 22 out of 30 on the Montreal Cognitive Assessment (MoCA) during initial assessment

Sponsors & Collaborators

• University of Arizona: lead

Study Sites (1)

St. Luke's Home

Tucson, Arizona, 85705, United States

Location

MeSH Terms

Conditions

Emergencies

Condition Hierarchy (Ancestors)

Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Jeannie K Lee, PharmD

  University of Arizona

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Study Record Dates

• First Submitted: August 22, 2016
• First Posted: August 25, 2016
• Study Start: August 1, 2016
• Primary Completion: August 1, 2018
• Study Completion: August 1, 2018
• Last Updated: November 1, 2018

Record last verified: 2018-10

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)