Developing and Implementing Meaningful Activities Facilitators in Geriatric Short Stay

NCT06080126 | Unknown

• 2 other identifiers: 69HCL22_07262023-A00490-45
• Study Type: interventional
• Target: 320
• Locations: 1 country
• Sites: 2

Brief Summary

Older people are particularly vulnerable to adverse effects of hospitalization, which can compromise their functional autonomy. The onset of confusion, loss of mobility or malnutrition is largely related to the context of hospitalization itself, which creates stressful situations for patients in addition to the acute pathology: change in the usual living environment, lack of human and reassuring interactions, lack of mobility related to the pathology or caused by the use of barriers or restraints. These geriatric complications can be prevented. Programs involving the intervention of volunteers or dedicated professionals with hospitalized patients have been developed. These "Meaningful Activities Facilitators" (MAF) have the task of preventing or limiting the deleterious effects of hospitalization on the older people, in particular by stimulating eating and walking, and by practicing social activities in line with the patient's lifestyle habits. This system has been set up in geriatric short-stay wards in the United Kingdom, where MAFs, who received specific training, are integrated into the care team and work with patients at risk. The integration of these MAFs has shown a reduction in the incidence and duration of delirium episodes, the use of psychotropic drugs, and the use of restraint. A study currently underway in Australia aims to reduce hospital-acquired complications through a program of mobilization, nutrition, and engagement of patients in constructive activities (the "Eat, Walk, Engage" program) implemented by a trained MAFs. The investigators hypothesis is that the implementation of MAFs in geriatric short-stay wards will reduce the incidence of geriatric complications associated with hospitalization. Objectives: The investigators objective is to study the feasibility and acceptability of integrating MAFs into the care teams of two geriatric short-stay services in France. The investigators will evaluate the adaptations to be proposed to the MAF model to make it relevant in our context from the point of view of patients, their relatives and professionals, and will study the effect of this intervention on the occurrence of complications and the functioning of the teams, its implementation and its costs. Perspectives: The results of this study will allow us to define if the MAFs intervention is feasible and acceptable in the French context, and if so, to propose an intervention model adapted to our context.

Conditions

Geriatric Care

Keywords

Meaningful activities facilitators; geriatric service

Outcome Measures

Primary Outcomes (1)

• Feasibility and acceptability of implementing meaningful activities facilitators (MAF) in a French short stay geriatric unit, from the perspective of professionals, MAF and patients/relatives.

  Criteria to conclude on feasibility will be the fulfilment of the following criteria during the intervention period (MAF implementation): * employment of two MAFs (one per participating unit, 0.5FTE), * SATIN and EEPMT Questionnaire

  From the implementation of a meaningful activities facilitators for a period of 4 months.

Study Arms (2)

Control

OTHER

Other: Control: per usual practice

Intervention

OTHER

Other: Intervention MAF

Interventions

Control: per usual practice OTHER

160 patients were included as per usual practice.

Control

Intervention MAF OTHER

160 patients were included with MAF intervention.

Intervention

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)

You may qualify if:

• Patient aged 65 and over
• admitted to a geriatric short-stay hospital for \> 72 hours
• Considered "at risk of complications related to hospitalisation": at least two of the following criteria:
• Clinical Frailty Scale (Rockwood Clinical Frailty Score
• At least one ADL-IADL dependency,
• Presence of known cognitive impairment,
• Patient confused on admission,
• History of confusional syndrome on previous hospitalisation or use of medication,
• Anxiety-depression (history or current pathology),
• Repeated falls (\>2 in a year) or fear of falling,
• Risk of sarcopenia (Score \>4 on the SARC-F questionnaire
• Presenting undernutrition or a risk of undernutrition (according to medical assessment, e.g. low BMI, anorexia, recent weight loss).
• Patient having been informed of the study and having signed an informed consent (for patients under guardianship, the consent of the guardian will be requested). For patients under guardianship, the patient will sign the consent in the presence of the guardian.
• Patient who understands and speaks French
• Patient affiliated to a social security scheme

You may not qualify if:

• Patient in palliative care for a terminal disease
• Re-hospitalised patients already included during a previous stay
• Patients under court protection

Sponsors & Collaborators

• Hospices Civils de Lyon: lead

Study Sites (2)

Geriatric Short Stay Department - Unit 3C of the Charpennes Hospital

Lyon, 69100, France

Location

University Department of Geriatric Medicine, Centre Hospitalier Lyon Sud

Lyon, 69495, France

Location

Central Study Contacts

Thomas GILBERT, MD

CONTACT

4.78.86.49.39; thomas.gilbert@chu-lyon.fr

Stephanie POUPON-BOURDY

CONTACT

6.61.23.43.28; stephanie.poupon-bourdy@chu-lyon.fr

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: The study will be conducted in a 2-phase approach corresponding to the 2 successive phases of the MRC guidance: * Phase 1: The adaptation of the intervention to our context will be based on a literature review and a qualitative study. * Phase 2: The feasibility and acceptability of the intervention will be assessed during a quasi-experimental before and after study conducted in two short-stay geriatric units.

Study Record Dates

• First Submitted: September 21, 2023
• First Posted: October 12, 2023
• Study Start: October 30, 2023
• Primary Completion: December 31, 2024
• Study Completion: April 30, 2025
• Last Updated: October 17, 2023

Record last verified: 2023-09

Data Sharing

• IPD Sharing: Will not share

Locations

FR (2)