Case Managers to Frail Older People a Randomized Controlled Trial

Study Overview
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Brief Summary
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The aim of is to test the effects of a model for care (case management) to older people with high healthcare consumption and functional dependency on healthcare consumption, quality of life, functional ability and experiences of care.

Official Title
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Case Managers to Frail Older People a Randomized Controlled Trial

Conditions
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Frail Elderly

Intervention / Treatment
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* Other: Case management


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: aged 65 or over need help with at least two activities of daily living been admitted to hospital on at least two occasions, or have had at least four contacts with outpatient or primary care during the previous twelve months, be able to communicate verbally have no cognitive impairment

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Case Management<br> | Other: Case management<br>* Nurses and a physiotherapist (PT) worked as case managers (CM). The intervention lasted 12 months and comprised 4 dimensions. The first was traditional CM tasks: assessment, planning, monitoring, care coordination and evaluation. Home visits were made at least once a month. The second and third was general and specific information related to the participants' situation. The fourth part included aspects of continuity and safety. The PT also paid home visits and made an assessment regarding physical function and balance. The intervention consisted of multidimensional prevention of falls and/or consequences of falls, and supporting and motivating the participant to increased physical activity. When those in the control group had participated for 12 months they were offered the intervention.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Health care consumption |  | two years (one year before vs after baseline) | 
| Health care costs |  | two years (one year before vs after baseline) | 
| Feelings of loneliness |  | baseline and then after 3,6,9,12,24 months | 
| Depressive symptoms |  | baseline and then after 3,6,9,12,24 months | 
| Health Related Quality of Life |  | baseline and then after 3,6,9,12,24 months | 
| Number of falls |  | baseline and then after 3,6,9,12,24 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Life Satisfaction |  | baseline and then after 6,12,24 months | 
| Health complaints |  | baseline and then after 3,6,9,12,24 months | 
| Knowledge about prescribed drugs |  | baseline and then after 3,6,9,12,24 months | 
| Attitudes towards prescribed drugs |  | baseline and then after 3,6,9,12,24 months | 
| Drug use |  | baseline and then after 3,6,9,12,24 months | 
| Activities and social participation |  | baseline and then after 3,6,9,12,24 months | 
| Functional capacity |  | baseline and then after 3,6,9,12,24 months | 
| Balance |  | baseline and then after 3,6,9,12,24 months | 
| Timed up and go (TUG) |  | baseline and then after 3,6,9,12,24 months | 
| Risk of falling |  | baseline and then after 3,6,9,12,24 months | 
| Fear of Falling |  | baseline and then after 3,6,9,12,24 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Case Management, Frail Elderly, Health Services Administration, Delivery of Health Care, Accidental Falls, Health Status, Health Care Economics