Transition in Care From Post-acute Services for the Elderly in Quebec

NCT05915156 | Completed

• 1 other identifier: CIUSSS-SMHC-20-21
• Study Type: interventional
• Target: 24
• Locations: 1 country
• Sites: 6

Brief Summary

An early discharge of frail elderly individuals from post-acute care services may lead to a decline in their ability to perform daily activities and cause social, emotional, and psychological distress. Montreal West Island Integrated University Health and Social Services Center in Quebec implemented a pilot program called Post-Acute Home Physiotherapy (PAHP) to address this concern. This program aimed to provide a timely and intense out-patient physiotherapy service to ensure maintenance and optimization of the physical capacities acquired in post-acute care and also to contribute acceleration of the turnover of rehabilitation beds. The objective of this study was to assess the impact of the PAHP program on the functional independence, physical and mental health of elderly individuals, as well as their safety. Additionally, it aimed to identify the healthcare needs, both physical and psychological, of elderly individuals after their discharge from post-acute care services.

Conditions

Older Adults; Rehabilitation; Physical Therapy; Functional Independence

Outcome Measures

Primary Outcomes (1)

• Functional Independence Measure

  Change in the Functional Independence Measure between 3 assessment points: week 0, week 8 and week 20. The FIM assesses an individual's independent performance in various areas, including self-care, sphincter control, transfers, locomotion, communication, and social cognition. This assessment consists of 18 items, and each item is assigned a score ranging from 1 to 7. The total score ranges from 18 (indicating the lowest level of independence and requiring significant assistance) to 126 (reflecting a high level of independence and minimal assistance needed).

  Change from week start of PAHP program (week 0) to end of program (week 8), 3-month follow-up (week 20)

Secondary Outcomes (4)

• Patient-Reported Outcomes Measurement Information System Global-10 survey

  Change from week start of PAHP program (week 0) to end of program (week 8), 3-month follow-up (week 20)

• Patient Global Impression of Change Scale

  Discharge from PAHP program (Week 8)

• Evaluation of safety parameters (Fall incidence, emergency visits, re-hospitalizations)

  Discharge from PAHP program (week 8) and at 3-month follow-up (week 20)

• Camberwell Assessment for the Need of the Elderly questionnaire

  Admission at PAHP program (week 0) and discharge from the program (week 8)

Study Arms (1)

Post-acute home physiotherapy program (PAHP)

OTHER

This health services research aimed to assess the effects of a post-acute home physiotherapy program that was designed to provide home physiotherapy services to patients recently discharged from acute or post-acute care.

Other: Post-acute home physiotherapy program

Interventions

Post-acute home physiotherapy program OTHER

This health services research assessed the effects of a post-acute home physiotherapy program that was designed to provide physical rehabilitation services to older adults recently discharged from acute or post-acute care. Under this program, every patient was attended by a physiotherapy technologist within 48 hours of being discharged and received home physiotherapy for a minimum of three days per week for a maximum of eight weeks.

Post-acute home physiotherapy program (PAHP)

Eligibility Criteria

• Age: 60 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Men and women aged ≥60 years
• Discharged home with/without home care services
• French or English fluency

You may not qualify if:

• \- Patients were excluded if they had an unstable medical, psychiatric, and post-surgical condition or a severe cognitive impairment (based on the assessment of the rehabilitation team).

Sponsors & Collaborators

• Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal: lead
• McGill University: collaborator
• Université du Québec à Trois-Rivières: collaborator
• Université de Montréal: collaborator

Study Sites (6)

CLSC de Dorval-Lachine

Lachine, Quebec, H8S 2G2, Canada

Location

CLSC de LaSalle

LaSalle, Quebec, H8N 1Y5, Canada

Location

LaSalle Hospital

LaSalle, Quebec, H8P 1C1, Canada

Location

CLSC de Pierrefonds

Pierrefonds, Quebec, H8Z 3H6, Canada

Location

CLSC du Lac-Saint-Louis

Pointe-Claire, Quebec, H9S 4S1, Canada

Location

Ste. Anne's Hospital

Sainte-Anne-de-Bellevue, Quebec, H9X 1Y9, Canada

Location

Related Publications (1)

• Ghai S, Chasse K, Renaud MJ, Guicherd-Callin L, Bussieres A, Zidarov D. Transition of care from post-acute services for the older adults in Quebec: a pilot impact evaluation. BMC Health Serv Res. 2024 Apr 3;24(1):421. doi: 10.1186/s12913-024-10818-2.

  PMID: 38570840 DERIVED

Study Officials

• Diana Zidarov, PhD

  Centre de Recherche Interdisciplinaire en Réadaptation

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal investigator

Study Record Dates

• First Submitted: May 31, 2023
• First Posted: June 22, 2023
• Study Start: April 1, 2021
• Primary Completion: December 31, 2021
• Study Completion: December 31, 2021
• Last Updated: June 23, 2023

Record last verified: 2023-06

Data Sharing

• IPD Sharing: Will not share

Locations

CA (6)