Anticipatory Care Planning Intervention for Older Adults at Risk of Functional Decline: A Primary Care Feasibility Study

NCT03902743 | Unknown

• 1 other identifier: B18/46
• Study Type: interventional
• Target: 64
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to explore the feasibility of delivering anticipatory care planning provided by nurses through a series of home visits. Many people with long-term health conditions can benefit from an anticipatory care plan as it helps them feel more in control of their life and allows them to manage changes in their health and well-being. The purpose of this study is to find out if effect of home visits by specially trained nurses for people aged 70 years and over who have been identified as being 'at risk' of developing frailty would be beneficial. Half of the patients in this study will receive home visits from trained nurses in addition to their usual care. Nurses will work with their GP, other healthcare providers and possibly family caregivers to plan and arrange any additional services that the participants require. The other half of patients in the study will receive usual care.

Conditions

Aging

Outcome Measures

Primary Outcomes (2)

• EQ-5D-5L

  Is a widely used self-reported generic measure of health reported quality of life that has been validated in different patient populations. The five-level version contains the same dimensions as the earlier three-level version but has been designed to provide greater reliability and sensitivity.

  10 minutes

• Center for Epidemiological Studies Depression Scale (CES-D)

  This 20- item scale has been used extensively with older adults. Respondents use a four choice scale to rate how they have felt in the past week expressing depressed mood.

  10 minutes

Secondary Outcomes (2)

• Patient Assessment of Chronic Illness Care (PACIC) Scale

  15 minutes

• Health Economic Evaluation

  15 minutes

Study Arms (2)

Intervention group

EXPERIMENTAL

Participants will receive an Anticipatory Care Plan

Other: Anticipatory Care Plan group

Control group

NO INTERVENTION

Usual care

Interventions

Anticipatory Care Plan group OTHER

The Anticipatory Care Plan will be delivered by a trained nurse. At the initial visit, the nurse will conduct a hollistic assessment using the EasyCare Assessment Tool. Following this visit, the nurse will draft a strucutred summary report of the home visit to include patient goals, preferences for care, identified problems and action list. The nurse will then consult with a pharmacist to identify any potential inappropriate prescribing. The nurse will then meet with the participants GP and review and provide feedback. The nurse will then re visit participants and discuss the report and agree a support plan and actions for follow up.

Intervention group

Eligibility Criteria

• Age: 70 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Older Adult (65+)

You may qualify if:

• Aged ≥70 years
• In receipt of a valid general medical services (GMS) card in the Republic of Ireland, or for Northern Ireland registered for NHS primary care services
• ability to complete a postal questionnaire

You may not qualify if:

• receiving specialist palliative care
• record of assessed cognitive impairment at the level that would impact their ability to complete screening postal questionnaire, outcome measures and participate in a patient care conference(s) (defined as Mini Mental State Examination (MMSE) ≤20)
• experiencing a psychotic episode at the time of recruitment
• hospitalised long-term, in a nursing home, homeless or in sheltered accommodation

Sponsors & Collaborators

• Queen's University, Belfast: lead
• Royal College of Surgeons, Ireland: collaborator
• National University of Ireland, Galway, Ireland: collaborator

Study Sites (1)

Queens University Belfast

Belfast, BT9 7BL, United Kingdom

RECRUITING

Related Publications (3)

• Brazil K, Cardwell C, Carter G, Clarke M, Corry DAS, Fahey T, Gillespie P, Hobbins A, McGlade K, O'Halloran P, O'Neill N, Wallace E, Doyle F. Anticipatory care planning for community-dwelling older adults at risk of functional decline: a feasibility cluster randomized controlled trial. BMC Geriatr. 2022 May 25;22(1):452. doi: 10.1186/s12877-022-03128-x.

  PMID: 35610581 DERIVED

• Corry DAS, Carter G, Doyle F, Fahey T, Gillespie P, McGlade K, O'Halloran P, O'Neill N, Wallace E, Brazil K. Successful implementation of a trans-jurisdictional, primary care, anticipatory care planning intervention for older adults at risk of functional decline: interviews with key health professionals. BMC Health Serv Res. 2021 Aug 25;21(1):871. doi: 10.1186/s12913-021-06896-1.

  PMID: 34433441 DERIVED

• Brazil K, Scott D, Wallace E, Clarke M, Fahey T, Gillespie P, O'Halloran P, Cardwell C, Carter G, McGlade K, Doyle F. Anticipatory care planning intervention for older adults at risk of functional decline: study protocol for a primary care cluster feasibility randomised trial. Trials. 2020 Feb 11;21(1):168. doi: 10.1186/s13063-020-4100-2.

  PMID: 32046767 DERIVED

Study Officials

• Kevin Brazil, PhD

  Queens University Belfast

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Kevin Brazil, PhD

CONTACT

(0)28 9097; k.brazil@qub.ac.uk

David Scott, PhD

CONTACT

(0)28 9097; david.scott@qub.ac.uk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor Kevin Brazil

Study Record Dates

• First Submitted: April 2, 2019
• First Posted: April 4, 2019
• Study Start: March 12, 2019
• Primary Completion: February 1, 2020
• Study Completion: August 1, 2020
• Last Updated: November 7, 2019

Record last verified: 2019-11

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL
• Time Frame: August 2021
• Access Criteria: Those requesting access will be required to submit a letter of intent to the study PI after which the research team will review their request

Locations

GB (1)