G-COACH
Quasi-experimental Before-and-after Study to Compare the Effectiveness of Geriatric Co-management on Preventing Functional Decline as Compared to Standard of Care in Older Cardiology Patients
Sponsor study identifier
interventional
454
1 country
1
Study Start
September 2016
Actual (reported)Primary Completion
December 2018
Actual (reported)Study Completion
July 2019
Actual (reported)The primary objective of the evaluation study is to determine if geriatric co-management is superior to standard of care in preventing functional decline in older patients admitted for acute heart disease or Transcatheter Aortic Valve Implementation (TAVI) to the cardiology units of the University Hospitals Leuven.
Registry-reported information. Elapsed time and enrollment totals alone do not measure study progress or recruitment pace.
July 2019
Actual (reported)Click on a node to explore related trials.
Some registry-reported names shown below are not yet linked in this graph.
Dates and qualifiers reported by the registry. Estimated dates do not confirm that a milestone has occurred.
August 24, 2016
Actual (reported)September 2016
Actual (reported)September 7, 2016
Actual (reported)December 2018
Actual (reported)July 2019
Actual (reported)Functional status on activities of daily living assessed using the Katz Index of Activities of Daily Living.
A difference of 1 point on the Katz Index will be considered clinically relevant.
Hospital admission (baseline) up to hospital discharge around an average of 12 days.
Functional decline in activities of daily living assessed using the Katz Index of Activities of Daily Living
A decline of 1 point between admission and discharge on the Katz Index will be considered clinically relevant.
Hospital admission (baseline) up to hospital discharge around an average of 12 days.
Functional decline in activities of daily living assessed using the Barthel Index of Activities of daily. Living.
A geriatric co-management intervention will be implemented on the cardiology units of the University Hospitals Leuven. Geriatric co-management is defined as a shared responsibility and decision making between the cardiology team and the geriatric team who provides complementary medical care in the prevention and management of geriatric problems. Patients included in the co-management program will undergo a comprehensive geriatric assessment within 24 hours of hospital admission.
The control group will receive the standard of care on the cardiology units. This includes multidisciplinary care with a one weekly multidisciplinary team meeting. Team members include a cardiology resident (supervised by a cardiologist), ward nurses, a physical therapist, a social worker and a dietician. A geriatric consultation team is available for consultation services if requested by the cardiology team.
A comprehensive geriatric assessment on admission will stratify patients in groups: 1. Low risk patients are expected to do well and will not receive co-management. 2. Medium risk patients are expected to develop complications. A geriatric nurse will visit the cardiology wards daily to co-manage these patients aiming to prevent complications by coordinating interdisciplinary care, implementing protocols, perform assessments and bedside education. The geriatric nurse will work collaboratively with the cardiology ward staff based on a shared decision making. Patients will receive early rehabilitation and discharge planning. 3. High risk patients have an acute geriatric syndrome. The geriatric nurse will visit the cardiology wards (see above), and a geriatrician will co-manage the acute geriatric syndrome(s). The geriatrician will work collaboratively with the cardiology ward staff based on a shared decision making. Patients will receive early rehabilitation and discharge planning.
Registry-reported names are shown in full. Names without a link have not yet been matched to a Syfrah profile.
University Hospitals Leuven
Leuven, Vlaams-Brabant, 3000, Belgium
Deschodt M, Van Grootven B, Jeuris A, Devriendt E, Dierckx de Casterle B, Dubois C, Fagard K, Herregods MC, Hornikx M, Meuris B, Rex S, Tournoy J, Milisen K, Flamaing J. Geriatric CO-mAnagement for Cardiology patients in the Hospital (G-COACH): study protocol of a prospective before-after effectiveness-implementation study. BMJ Open. 2018 Oct 21;8(10):e023593. doi: 10.1136/bmjopen-2018-023593.
Johan Flamaing, PhD, MD
Universitaire Ziekenhuizen KU Leuven
Koen Milisen, PhD, MSN
University of Leuven
Mieke Deschodt, PhD, MSN
University of Leuven
454 participants (actual enrollment reported by the registry).
First Submitted
August 24, 2016
First Posted
September 7, 2016
Study Start
September 2016
Actual (reported)Hospital admission (baseline), hospital discharge around an average of 12 days, and at 30 days, 3 months and 6 months follow-up after hospital discharge.
Community mobility assessed using the Life-Space assessment.
Hospital admission (baseline), and at 30 days, 3 months and 6 months follow-up after hospital discharge.
Short Physical Performance Test (SPPB).
Hospital admission (baseline), up to at hospital discharge around an average of 12 days.
Peak handgrip force assessed at the dominant side with the elbow at 90° of flexion, and the forearm and wrist in a neutral position.
Hospital admission (baseline) up to hospital discharge around an average of 12 days.
Symptomatic infections defined by a clinical diagnosis of pneumonia, urinary tract infection, sepsis and wound infection.
Hospital admission (baseline) up to hospital discharge around an average of 12 days.
Experiences by the intervention participants using focus group discussions and individual interviews.
Through study completion, an average of 1 year.
Reach of the intervention using structured observations and process indicators.
Through study completion, an average of 1 year.
Fidelity of the intervention using structured observations and process indicators.
Through study completion, an average of 1 year.
Contact the study team to confirm eligibility.
Primary Completion
December 2018
Actual (reported)Study Completion
July 2019
Actual (reported)Last Updated
February 13, 2020
Record last verified: 2020-02
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Source: ClinicalTrials.gov.
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