Clinical trial NCT01703689: Impact of Educational and Professional Supportive Interventions on Nursing Home Quality Indicators
Official title: Impact of Either Audit and Feedback Only or Audit and Feedback Associated to Cooperative Work Meetings Between Hospital Geriatricians and Nursing Home Staff on Quality Indicators and Health Care Practices in Nursing Homes.
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Quality Indicators
Physical Disability
Keywords: Quality indicators
quality of care
nursing home
long-term care unit
nursing home organisation
nursing home structure
disability
dependence
functional decline
functional impairment
older adults
elderly
audit and feedback
cooperative work
geriatrician
medication
hospitalisation
comorbidity
Lead sponsor: Agence Régionale de la Santé - Midi Pyrénées
Sponsor class: OTHER_GOV
Collaborators: name: Observatoire Régional de la Santé Midi-Pyrénées (ORSMIP)
First posted: 2012-10-10
Enrollment: 8039
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: Introduction: Efficacy of audit and feedback interventions on nursing home (NH)quality indicators is not well-established.

The main objective: The main purpose of the IQUARE study was to examine the impact of two types of audit and feedback interventions on NH quality indicators and on residents dependence levels in a 18-month follow-up.

Study hypothesis: We hypothesised that audit and feedback associated to educational and professional supportive interventions are more efficacy in improving NH quality indicators than audit and feedback only.

Secondary objectives: Investigate the impact of the interventions on

1. Residents:

   * Functional decline rate
   * Drug prescriptions (quantity and quality)
   * Prevalence of adverse health outcomes (e.g., falls)
2. NHs:

   * Planning and implementation of therapeutic measures

Detailed description: IQUARE is a multicentric individually-tailored controlled trial comparing two types of audit and feedback interventions:

* audit and feedback associated to cooperative work meetings between hospital geriatricians and nursing home (NH) staff in a 6-month intervention (strong intervention)
* audit and feedback only (light intervention) Power statistics and sample size calculations indicated that each group should be composed of at least 2 500 individuals. The strong intervention will last 6 months and is composed of two face-to-face cooperative meetings (hospital geriatricians and NH staff). Data will be collected at baseline and in a 18-month follow-up.

Eligibility criteria: Inclusion Criteria:

* Nursing homes (NH) voluntarily accepted to participate in the study.
* NH residents of both sex
* Residents living in the NH for ≥ 30 days
* Residents and their general practitioner (GP) having received information about the study
* NH residents do not voluntarily decline to participate in the study

Exclusion Criteria:

* NH currently participating in another interventional study
* GP of NH residents refused participation in the study.

Primary outcomes:
measure: Change from baseline in nursing home quality indicators at 18 months
timeFrame: baseline and 18-month follow-up
Secondary outcomes:
measure: Onset of dependence in activities of daily living from baseline to 18 months follow-up
timeFrame: baseline and 18-month follow-up
Other outcomes:
measure: Reduction in the prescription of psychotropic drugs from baseline to 18-month follow-up
timeFrame: baseline and 18-month follow-up
Locations:
city: Albi
country: France
facility: EHPAD le parc ALBI
city: Argelès-Gazost
country: France
facility: EHPAD Canarie Vieuzac
city: Assier
country: France
facility: MAPAD Les Pradels
city: Auch
country: France
facility: Les Jardins auscitains
city: Auch
country: France
facility: Les jardins d´Agape
city: Auch
country: France
facility: Saint Dominique
city: Aureilhan
country: France
facility: EHPAD Résidence Mutualiste La Pyrénéenne
city: Bagnères-de-Bigorre
country: France
facility: EHPAD Résidence Castelmouly
city: Barbazan
country: France
facility: ONAC résidence paul oddo
city: Baziège
country: France
facility: Korian Les Ainés du Lauragais
city: Beaumont-de-Lomagne
country: France
facility: Notre Dame
city: Belmont-sur-Rance
country: France
facility: Ehpad Sherpa
city: Bessières
country: France
facility: Le Pastel
city: Bessières
country: France
facility: Le Pastourel
city: Bessières
country: France
facility: Sainte-Cécile
city: Blagnac
country: France
facility: Emeraude
city: Blagnac
country: France
facility: Résidence de Vinci
city: Brassac
country: France
facility: EHPAD St joseph de BRASSAC
city: Bretenoux
country: France
facility: EHPAD Robert Durrieu
city: Cahors
country: France
facility: M.R Orpea
city: Cajarc
country: France
facility: EHPAD La Cascade
city: Calmont
country: France
facility: Les Roses
city: Capdenac-Gare
country: France
facility: EHPAD Gai Logis
city: Capdenac-gare
country: France
facility: EHPAD La Croix Bleue
city: Carmaux
country: France
facility: EHPAD le bosc Carmaux
city: Castelginest
country: France
facility: Tour Tottier
city: Castelmaurou
country: France
facility: La Cerisaie
city: Castelnau-d´Estrétefonds
country: France
facility: Notre Dame du Bon Accueil
city: Castelnau-Montratier
country: France
facility: M.R St Luc - Castelnau Montratier
city: Castelsarrasin
country: France
facility: Chic Ehpad C.H
city: Castres
country: France
facility: EHPAD Villégiale Saint Jacques CHIC - CASTRES/MAZAMET
city: Catus
country: France
facility: MAPA Résidence St Astier
city: Caylus
country: France
facility: EHPAD Caylus - Val de Bonnette
city: Cazals
country: France
facility: EHPAD Arc-En-Ciel
city: Cazères
country: France
facility: Jeanne Penent
city: Cologne
country: France
facility: ALLIANCE
city: Cruejouls
country: France
facility: EHPAD St Laurent
city: Cépet
country: France
facility: Castelgirou
city: Dourgne
country: France
facility: EHPAD les arcades
city: Ercé
country: France
facility: EHPAD Saint-Philippe
city: Fronton
country: France
facility: Saint-Joseph
city: Gaillac
country: France
facility: EHPAD St ANDRE CH de Gaillac
city: Gaillac
country: France
facility: EHPAD St JEAN CH de Gaillac
city: Galan
country: France
facility: EHPAD Accueil du Frère Jean
city: Galan
country: France
facility: EHPAD La Baïse
city: Gimont
country: France
facility: Ch Gimont
city: Gramat
country: France
facility: Foyer Pierre Bonhomme
city: Gramat
country: France
facility: MR Charles de Gaulle
city: Gramat
country: France
facility: MR Louis Conte
city: Gramond
country: France
facility: EHPAD Saint Dominique
city: Graulhet
country: France
facility: Ehpad de Graulhet
city: Grenade
country: France
facility: Saint-Jacques
city: Grisolles
country: France
facility: Ste Sophie
city: Ibos
country: France
facility: EHPAD Résidence Zélia
city: Juillan
country: France
facility: EHPAD Le Jonquère
city: La Bastide-de-Sérou
country: France
facility: EHPAD Gustave Pédoya
city: Labastide-Rouairoux
country: France
facility: EHPADRouanet-Iché de LABASTIDE-ROUAIROUX
city: Labruguière
country: France
facility: EHPADL'Oustal d'En Thibaud
city: Lacapelle-Marival
country: France
facility: M.R La Miséricorde
city: Lacaune
country: France
facility: EHPAD St vinçent de paul
city: Lafrançaise
country: France
facility: Résidence du Lac
city: Lagrave
country: France
facility: EHPAD résidence le grand champ
city: Laguépie
country: France
facility: Les Causeries
city: Laroques d´Olmes
country: France
facility: Centre hospitalier du Pays d´Olmes - Laroques d´Olmes
city: Larrazet
country: France
facility: La Barbacane
city: Latronquière
country: France
facility: MAPAD Les Ségalines
city: Launaguet
country: France
facility: Résidence Paul et Lisa
city: Lautrec
country: France
facility: Ehpad Les Quietudes
city: Lavelanet
country: France
facility: Centre hospitalier du Pays d´Olmes - Résidence du Touyre
city: Le Cabanial
country: France
facility: La Vendinelle
city: Lectoure
country: France
facility: Ehpad Barrere
city: Lectoure
country: France
facility: Ehpad Feral
city: Livinhac-le-Haut
country: France
facility: EHPAD L´Oasis
city: Lourdes
country: France
facility: EHPAD La Madone
city: Lourdes
country: France
facility: EHPAD Le Petit Jer
city: Lugan
country: France
facility: EHPAD Notre Dame des Grâces
city: Lunac
country: France
facility: EHPAD Le Paginet
city: Luzech
country: France
facility: MAPAD Les logis de l´Impernal
city: Luzenac
country: France
facility: EHPAD Le santoulis
city: L´ Isle-en-Dodon
country: France
facility: EHPAD Faux-Bourg Saint-Adrien
city: L´ Isle-Jourdain
country: France
facility: Saint-Jacques
city: Léguevin
country: France
facility: Résidence Curtis
city: Marcillac-Vallon
country: France
facility: EHPAD Saint Joseph
city: Masseube
country: France
facility: Val de Gers
city: Mazères
country: France
facility: EHPAD Le Clos du Raunier
city: Mercuès
country: France
facility: MR Beau Séjour
city: Millau
country: France
facility: EHPAD du CH Millau - St Michel
city: Millau
country: France
facility: EHPAD Les Charmettes
city: Mirepoix
country: France
facility: EHPAD Louise de Roquelaure
city: Monestiés
country: France
facility: EHPAD de MONESTIES
city: Montauban
country: France
facility: Ange Gardien
city: Montauban
country: France
facility: Montauban - Ehpad Ushpa
city: Montauban
country: France
facility: MR Saint Orens
city: Montbeton
country: France
facility: St Jean Marie Vianney
city: Montcuq
country: France
facility: MR Sainte-Marie
city: Montfaucon
country: France
facility: M.R La Roseraie
city: Montredon
country: France
facility: MR L´Etoile du Soir
city: Montréjeau
country: France
facility: L´Hermitage
city: Mur-de-Barrez
country: France
facility: EHPAD Rés. Parc de la Corette
city: Muret
country: France
facility: Le Barry
city: Muret
country: France
facility: Résidence Marie-Antoinette
city: Nant
country: France
facility: EHPAD Résidence les deux vallées
city: Nant
country: France
facility: EHPAD Sainte Marie les Ursulines
city: Orleix
country: France
facility: EHPAD Résidence du Lac
city: Pechbonnieu
country: France
facility: Centre Alzheimer Marie-Louise
city: Pibrac
country: France
facility: La Houlette
city: Pins-Justaret
country: France
facility: La Tranquilité
city: Plaisance du Gers
country: France
facility: Cité Saint Joseph
city: Plaisance-du-Touch
country: France
facility: Le Prat
city: Pointis-de-Rivière
country: France
facility: Oasis-Palmeraie
city: Pont de Salars
country: France
facility: EHPAD La résidence du Lac
city: Portet-sur-Garonne
country: France
facility: L´Auta
city: Pradines
country: France
facility: EHPAD Résidence du petit bois
city: Prayssac
country: France
facility: M.R Les balcons du Lot
city: Puy-l´Évêque
country: France
facility: M.R Les Lavandes
city: Puygouzon
country: France
facility: EHPAD la Maison Du Lac
city: Quint-Fonsegrives
country: France
facility: Résidence Isatis
city: Rabastens
country: France
facility: EHPAD Hermitage et Terrasses de Rabastens
city: Requista
country: France
facility: EHPAD Jean Baptiste Delfau
city: Revel
country: France
facility: EHPAD de Revel
city: Rignac
country: France
facility: EHPAD Les Rosiers
city: Riscle
country: France
facility: Bel Adour
city: Rodez
country: France
facility: EHPAD Bon Accueil
city: Rodez
country: France
facility: EHPAD Julie Chauchard
city: Rodez
country: France
facility: EHPAD Saint Cyrice
city: Rodez
country: France
facility: EHPAD Saint Jacques du CH
city: Roquecourbe
country: France
facility: EHPAD Le clos de Siloe
city: Saint-Affrique
country: France
facility: EHPAD La Miséricorde
city: Saint-Alban
country: France
facility: Les Clos des Amandiers
city: Saint-Antonin-Noble-Val
country: France
facility: Résidence de l´abbaye
city: Saint-Clar
country: France
facility: Lavallée
city: Saint-Côme-d´Olt
country: France
facility: EHPAD Les Galets d´Olt
city: Saint-Gaudens
country: France
facility: Le Mas Saint-Pierre
city: Saint-Gaudens
country: France
facility: L´Ensoleillade
city: Saint-Geniez-d´Olt
country: France
facility: EHPAD de l´Hôpital local
city: Saint-Girons
country: France
facility: Centre hospitalier Ariège Couserans
city: Saint-Laurent-d´Olt
country: France
facility: EHPAD Le Val d´Olt
city: Saint-Lizier
country: France
facility: EHPAD Hector d´Ossun
city: Saint-Lys
country: France
facility: Les Rossignols
city: Saint-Lys
country: France
facility: Maréchal Leclerc
city: Saint-Lys
country: France
facility: Résidence La Joie de Vivre
city: Saint-Sernin-sur-Rance
country: France
facility: EHPAD Clos St François
city: Saint-Sulpice
country: France
facility: Ehpad Chez Nous
city: Salvagnac
country: France
facility: EHPAD Petite Plaisance SAVAGNAC
city: Saverdun
country: France
facility: EHPAD Vert Coteau
city: Saïx
country: France
facility: EHPAD Les grands chênes
city: Seix
country: France
facility: EHPAD Paul Ané
city: Septfonds
country: France
facility: La Septfontoise
city: Serviès
country: France
facility: Ehpad Le Pre Fleuri
city: Siradan
country: France
facility: EHPAD Sainte Marie
city: Sorèze
country: France
facility: EHPAD St Vinçent et Ste Croix
city: St AMANS DES COTS
country: France
facility: EHPAD St Jean
city: Toulouse
country: France
facility: Les Tourelles
city: Toulouse
country: France
facility: Maurice Garrigou
city: Toulouse
country: France
facility: Plénitude Saint-Michel
city: Toulouse
country: France
facility: Résidence Saint-Simon
city: Toulouse
country: France
facility: La Cotonnière
city: Toulouse
country: France
facility: Arc-en-Ciel
city: Toulouse
country: France
facility: EHPAD Les Fontaines
city: Toulouse
country: France
facility: La Pastellière
city: Toulouse
country: France
facility: Orpéa Crampel
city: Toulouse
country: France
facility: Caroline Baron
city: Tournefeuille
country: France
facility: Le Grand Marquisat
city: Trie-sur-Baïse
country: France
facility: EHPAD Résidence Les Rives du Pélam
city: Trébas
country: France
facility: Ehpad Belcantou
city: Valence D Agen
country: France
facility: EHPAD du Centre Hospitalier Des Deux Rives
city: Vayrac
country: France
facility: M.R Résidence Valpré
city: Verdalle
country: France
facility: EHPAD ND de Touscayrats
city: Verdun-sur-Garonne
country: France
facility: MR Saint Jacques
city: Vic-en-Bigorre
country: France
facility: EHPAD La Clairière - Les Acacias
city: Vic-fezensac
country: France
facility: Ch Vic-Fezensac
city: Vic-Fezensac
country: France
facility: Le Château fleuri
city: Villefranche-de-Rouergue
country: France
facility: EHPAD Sainte Claire
city: Villefranche-de-Rouergue
country: France
facility: EHPAD Sud Rulhedu CH
city: Villeneuve-Tolosane
country: France
facility: Le Pin
Study officials:
affiliation: La Grave- Casselardit University Hospital Centre, Service de Médecine Interne et Gérontologie Clinique - Gérontopôle
name: Yves Rolland, MD, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Dubucs X, de Souto Barreto P, Rolland Y. Organizational and environmental factors associated with transfers of nursing home residents to emergency departments. Eur Geriatr Med. 2018 Jun;9(3):339-346. doi: 10.1007/s41999-018-0059-x. Epub 2018 May 8.
citation: Cool C, Cestac P, McCambridge C, Rouch L, de Souto Barreto P, Rolland Y, Lapeyre-Mestre M. Reducing potentially inappropriate drug prescribing in nursing home residents: effectiveness of a geriatric intervention. Br J Clin Pharmacol. 2018 Jul;84(7):1598-1610. doi: 10.1111/bcp.13598. Epub 2018 May 14.
citation: Laffon de Mazieres C, Lapeyre-Mestre M, Vellas B, de Souto Barreto P, Rolland Y. Organizational Factors Associated With Inappropriate Neuroleptic Drug Prescribing in Nursing Homes: A Multilevel Approach. J Am Med Dir Assoc. 2015 Jul 1;16(7):590-7. doi: 10.1016/j.jamda.2015.01.092. Epub 2015 Mar 10.