Short-term Effects of an Inpatient Geriatric Consultation Team on Geriatric Syndrome Patients

NCT03840759 | Completed

• 1 other identifier: CMRPG8F1571
• Study Type: interventional
• Target: 59
• Locations: 0 countries
• Sites: N/A

Brief Summary

Patients admitted to acute ordinary wards in a medical center in Southern Taiwan from an elder-integrated outpatient department or emergency room from January 2017 to December 2017 were included if they met the following criteria: (i) age 65 years or older, (ii) Barthel index score ≦60 and (iii) with at least one of the following geriatric syndromes: unsteady gait or easy-to-fall ( falls ≧ 2 in last 1 year), malnutrition with Mini Nutritional Assessment-Short Form screening score \< 12, urinary incontinence, pressure sores, dementia, delirium, depression, polypharmacy (≧8 medications), and excessive utilization of healthcare facilities (admission≧2, visit Emergency≧2, or visit outpatient department≧12 in one month). Patients were excluded if they were in a vegetative state, under palliative care or terminally ill and suffering from acute illness needing to be transferred to or cared for in the Intensive Care Unit. Human participant approval was obtained from the Chang Gung Medical Foundation Institutional Review Board before data collection. Participants were recruited from the ordinary wards by research assistants who screened the admission list every morning if they met the inclusion criteria. Then, the detail of the research was explained to the patients and families. They were allowed to choose to be in the control group or the intervention group. After the participants and or family agreed, informed consent was signed. For those who were cognitively impaired or suffered from dementia, informed consent was signed by their relative or partner. For the intervention group, a geriatric physician was consulted and recommendations were made by the geriatric consultant after a complete geriatric assessment. Besides the geriatric physician, the investigator's multidisciplinary team included a social worker, nutritionist and physical therapist. In the control group, the participants only received routine hospital care and no geriatric physician was consulted.

Conditions

Depression; Senile Dementia

Outcome Measures

Primary Outcomes (3)

• readmission rate

  compare the differences of readmission rates between the intervention and control groups

  readmission rate within one month after discharge

• readmission rate

  compare the differences of readmission rates between the intervention and control groups

  readmission rate within three months after discharge

• readmission rate

  compare the differences of readmission rates between the intervention and control groups

  readmission rate within six months after discharge

Secondary Outcomes (3)

• mortality rate

  mortality rate within one month after discharge

• mortality rate

  mortality rate within three months after discharge

• mortality rate

  mortality rate within six months after discharge

Study Arms (1)

usual care

EXPERIMENTAL

For the intervention group, a geriatric physician was consulted and recommendations were made by the geriatric consultant and inpatient geriatric consultation team after a complete geriatric assessment (CGA). The CGA includes the assessment of depression, dementia, physical performance of Activity of Daily Living (ADL) and nutrition using Geriatric Depression Scale (GDC-15), Mini-Mental State Examination (MMSE), Barthel Index (BI), and Mini Nutritional Assessment-Short Form (MNA®-SF) respectively. Besides the geriatric physician, our multidisciplinary team included a social worker, nutritionist and physical therapist. In the control group, the participants only received routine hospital care and no geriatric physician was consulted.

Other: inpatient geriatric consultation team

Interventions

inpatient geriatric consultation team OTHER

For the intervention group, a geriatric physician was consulted and recommendations were made by the geriatric consultant after a complete CGA.

usual care

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Older Adult (65+)

You may qualify if:

• (i) age 65 years or older, (ii) Barthel index (BI) \[18\] score ≦60 and (iii) with at least one of the following geriatric syndromes: unsteady gait or easy-to-fall ( falls ≧ 2 in last 1 year), malnutrition with Mini Nutritional Assessment-Short Form (MNA®-SF) screening score \< 12, urinary incontinence, pressure sores, dementia, delirium, depression, polypharmacy (≧8 medications), and excessive utilization of healthcare facilities (admission≧2, visit Emergency≧2, or visit outpatient department≧12 in one month)-

You may not qualify if:

• Patients were excluded if they were in a vegetative state, under palliative care or terminally ill and suffering from acute illness needing to be transferred to or cared for in the Intensive Care Unit.

Sponsors & Collaborators

• Chang Gung Memorial Hospital: lead

MeSH Terms

Conditions

Depression; Alzheimer Disease

Condition Hierarchy (Ancestors)

Behavioral Symptoms; Behavior; Dementia; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Tauopathies; Neurodegenerative Diseases; Neurocognitive Disorders; Mental Disorders

Study Officials

• Song-Seng Loke

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 30, 2019
• First Posted: February 15, 2019
• Study Start: January 1, 2017
• Primary Completion: December 31, 2017
• Study Completion: December 31, 2017
• Last Updated: February 15, 2019

Record last verified: 2016-12

Data Sharing

• IPD Sharing: Will not share