Clinical trial NCT03730285: Fast-track Discharge With Telemedicine
Official title: Fast-track Discharge Combined With Treatment and Rehabilitation at Home With Telemedicine
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Emergencies
Keywords: telemedicine, patient satisfaction, randomization
Lead sponsor: Kolding Sygehus
Sponsor class: OTHER
First posted: 2018-11-05
Enrollment: 40
Sex: ALL
Minimum age (years): 75
Standard ages: OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: SUPPORTIVE_CARE

Brief summary: Evaluation of discharge after arrival at emergency unit, Kolding Hospital combined with treatment and rehabilitation in the home either by telemedicine or the usual treatment

Detailed description: Participants are acute in-patients at the Medical Department, Kolding Hospital. Participants shall be informed about the project, and all screened initially within 30 minutes. After 3-4 hours adjusted treatment and possible need for new investigations are conducted. Patients are randomized at discharge to home treatment with rounds via telemedicine with support of emergency team of nurses or hospitalization in emergency unit. Observations, treatment and rehabilitation follow the same standards and guidelines for all patients. The cohort of patients is recruited between Oct 1, 2015 until January 1, 2016. The study is a randomized quality evaluation study of patient satisfaction, of the emergency team at Kolding Municipality, re-admittance rate, use of other health services, and new services from the municipality.

Eligibility criteria: Inclusion Criteria:

* municipal home care at admittance
* admitted to medical emergency care unit at Kolding Hospital

Exclusion Criteria:

* ketoacidosis,
* hyperosmolar diabetic coma,
* serious hypercalcemia,
* acute renal insufficiency with serum-creatinin \> 175 mmol/l,
* serious cardiac failure
* septicemia
* acute coronary disease
* apoplexia cerebri
* neuroinfection
* progressive or active cancer
* hepatic disease
* serious psychiatric disease

Primary outcomes:
measure: Walking distance
timeFrame: 3 months
Secondary outcomes:
measure: Days of admittance
timeFrame: 3 months
measure: Fall in home
timeFrame: 3 months
Other outcomes:
Locations:
Study officials:
affiliation: Kolding Sygehs, Medical Department
name: Ole W Rasmussen, DrMedScie
role: PRINCIPAL_INVESTIGATOR
References:
citation: van Mastrigt GA, Joore MA, Nieman FH, Severens JL, Maessen JG. Health-related quality of life after fast-track treatment results from a randomized controlled clinical equivalence trial. Qual Life Res. 2010 Jun;19(5):631-42. doi: 10.1007/s11136-010-9625-5. Epub 2010 Mar 26.
citation: Shea S, Weinstock RS, Teresi JA, Palmas W, Starren J, Cimino JJ, Lai AM, Field L, Morin PC, Goland R, Izquierdo RE, Ebner S, Silver S, Petkova E, Kong J, Eimicke JP; IDEATel Consortium. A randomized trial comparing telemedicine case management with usual care in older, ethnically diverse, medically underserved patients with diabetes mellitus: 5 year results of the IDEATel study. J Am Med Inform Assoc. 2009 Jul-Aug;16(4):446-56. doi: 10.1197/jamia.M3157. Epub 2009 Apr 23.
citation: Mayes PA, Silvers A, Prendergast JJ. New direction for enhancing quality in diabetes care: utilizing telecommunications and paraprofessional outreach workers backed by an expert medical team. Telemed J E Health. 2010 Apr;16(3):358-63. doi: 10.1089/tmj.2009.0110.