NCT03883425

Brief Summary

The purpose of the study is to develop frailty and complexity computation algorithms based on the French version of the interRAI-HC and, in doing so, to provide homecare nurses with valid and reliable screening tools for their routine practice. By relying on a prospective observational case-control longitudinal study, the study intends to assess the predictive validity of the proposed indices with respect to undesirable health outcomes. Repeated measurement occasions, separated by 6-month intervals, will also allow for estimation of intra-individual change in frailty and complexity. In the study, elders living in the community and aged 65 or older are the target population, and three samples will be considered based on the a priori risks of adverse outcomes (case 1: formal home service recipients; case 2: formal home care recipients; control: free of formal home care or service). These groups will be compared on the observed rates of frailty and complexity and on their evolution over time. Results will allow for identification of subgroups of the aged population for whom early screening of frailty and complexity appears most relevant. Based on the findings, practice guideline will be proposed. They will entail the interpretation of the scores and recommendations for mounting adapted preventive strategies. Finally, the study will contribute to enhancing knowledge on the relation between frailty, a well-known concept in gerontology, and complexity, a concept increasingly referred to in the care literature but that still deserves operational and consensual definitions.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
231

participants targeted

Target at P75+ for all trials

Timeline
Completed

Started Sep 2018

Typical duration for all trials

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

September 1, 2018

Completed
7 months until next milestone

First Submitted

Initial submission to the registry

March 18, 2019

Completed
2 days until next milestone

First Posted

Study publicly available on registry

March 20, 2019

Completed
1.7 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

November 30, 2020

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

November 30, 2020

Completed
Last Updated

December 2, 2020

Status Verified

December 1, 2020

Enrollment Period

2.2 years

First QC Date

March 18, 2019

Last Update Submit

December 1, 2020

Conditions

Keywords

Home Care ServicesGeriatric AssessmentAgingFrailtyComplexityNursing

Outcome Measures

Primary Outcomes (4)

  • Frailty Index

    Index with a value ranging from 0 to 100, computed as the sum of health deficits recorded with the interRAI-HC MDS divided by the number of deficits considered. Replication of Ludwig and Busnel, BMC, 2017 (REF2)

    at baseline

  • Complexity Index

    Index with a value ranging from 0 to 100, computed as the sum of complexity items recorded with the interRAI-HC MDS divided by the number of items considered.

    at baseline

  • Change in frailty Index

    Change in the frailty index value; Expressed as a proportion, with the frailty index value at baseline as denominator and the observed frailty value as numerator.

    at 6 months and at 12 months

  • Change in complexity Index

    Change in the complexity index value; Expressed as a proportion, with the complexity index value at baseline as denominator and the observed complexity value as numerator.

    at 6 months and at 12 months

Secondary Outcomes (5)

  • Number of participants with falls

    at 6 month, at 12 months

  • Number of participants with hospitalizations

    at 6 month, at 12 months

  • Number of participants with physician visits

    at 6 month, at 12 months

  • Number of participants with emergency admissions

    at 6 month, at 12 months

  • Mortality rate

    at 6 month, at 12 months

Study Arms (3)

Case 1: formal home service recipients

Adults aged 65 or older living at home who receive formal home service (household, meal delivery, transportation, shopping) at least one a week

Other: interRAI-HC assessments

Case 2: formal home care recipients

Adults aged 65 or older living at home who receive formal home care (shower/bath nursing assistance, nursing care) at least once a week

Other: interRAI-HC assessments

Control: free of formal home care or home service

Adults aged 65 or older living at home who do not receive formal home care or home service.

Other: interRAI-HC assessments

Interventions

Standardized geriatric assessments done with the interRAI-HC instrument (Canadian French version 9.1) by trained nurses

Case 1: formal home service recipientsCase 2: formal home care recipientsControl: free of formal home care or home service

Eligibility Criteria

Age65 Years+
Sexall
Age GroupsOlder Adult (65+)
Sampling MethodNon-Probability Sample
Study Population

Community-dwelling older adults (aged 65 or older), fluent in French, living at home in Canton Geneva, Switzerland and volunteering to participate to the study.

You may qualify if:

  • living in the community (private home)
  • resident of Canton Geneva, Switzerland
  • ability to hold a conversation in French (expression, comprehension)
  • oriented in time and space

You may not qualify if:

  • living in hospital / nursing home
  • not resident of Canton Geneva, Switzerland
  • not fluent in French
  • disoriented in time and space
  • person under tutorship

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

School of Health Sciences Geneva

Geneva, 1206, Switzerland

Location

Related Publications (4)

  • Morris JN, Fries BE, Steel K, Ikegami N, Bernabei R, Carpenter GI, Gilgen R, Hirdes JP, Topinkova E. Comprehensive clinical assessment in community setting: applicability of the MDS-HC. J Am Geriatr Soc. 1997 Aug;45(8):1017-24. doi: 10.1111/j.1532-5415.1997.tb02975.x.

    PMID: 9256857BACKGROUND
  • Ludwig C, Busnel C. Derivation of a frailty index from the resident assessment instrument - home care adapted for Switzerland: a study based on retrospective data analysis. BMC Geriatr. 2017 Sep 7;17(1):205. doi: 10.1186/s12877-017-0604-3.

    PMID: 28882127BACKGROUND
  • Busnel C, Vallet F, Ashikali EM, Ludwig C. Assessing multidimensional complexity in home care: congruencies and discrepancies between patients and nurses. BMC Nurs. 2022 Jun 24;21(1):166. doi: 10.1186/s12912-022-00942-x.

  • Ludwig C, Busnel C. Protocol of a case-control longitudinal study (fraXity) assessing frailty and complexity among Swiss home service recipients using interRAI-HC assessments. BMC Geriatr. 2019 Aug 5;19(1):207. doi: 10.1186/s12877-019-1230-z.

MeSH Terms

Conditions

Frailty

Condition Hierarchy (Ancestors)

Pathologic ProcessesPathological Conditions, Signs and Symptoms

Study Officials

  • Catherine Ludwig, PhD

    School of Health Sciences Geneva

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
observational
Observational Model
CASE CONTROL
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
UAS associate professor

Study Record Dates

First Submitted

March 18, 2019

First Posted

March 20, 2019

Study Start

September 1, 2018

Primary Completion

November 30, 2020

Study Completion

November 30, 2020

Last Updated

December 2, 2020

Record last verified: 2020-12

Data Sharing

IPD Sharing
Will share

Data and analytical codes will be shared in the form of computerized data files in SPSS format (\*.sav, \*.sps). Variable specification are written in SPSS syntaxes (\*.sps files). Syntaxes define for each variable (raw or recoded) its short name, its type (date, string, numerical), its label, its response values and labels, the values associated with missing data and the measurement scale. Whenever relevant, the syntax is annotated, providing, for example, the reference of the published guideline for recoding. All variable specifications are summarized in a codebook (generated by SPSS), which is completed by specifications on the data collection procedure and on the sources used as references for recoding. The dataset is free of individual personal information (named, dated of birth, addresses, etc.); unique numerical codes are used to identify participants.

Shared Documents
STUDY PROTOCOL, ANALYTIC CODE
Time Frame
At the end of the study, the recoded data set (SPSS format, cleaned and coded), the data codebook, references for the measurement instruments and all other relevant information related to the project (e.g. protocol) will be deposited at DARIS/FORS for data sharing and reuse.
Access Criteria
Data access and reuse, as well as intellectual property rights issues will be addressed through FORS standard contractual arrangements for a) the conditions of data deposit and b) the conditions of data use by a third party.
More information

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