Clinical trial NCT04398797: Prevention of AcuTe admIssioN Algorithm (PATINA)
Official title: Prevention of AcuTe admIssioN Algorithm (PATINA) - The Effect of a Notification Algorithm and a Digital Decision Support Tool
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Avoid Acute Hospitalizations
Keywords: Algorithm
Community dwelling
Health care utilization
Acute hospitalization
Lead sponsor: Region of Southern Denmark
Sponsor class: OTHER
Collaborators: name: Odense Municipality, Denmark
name: Kerteminde Municipality, Denmark
name: Svendborg Municipality, Denmark
First posted: 2020-05-21
Enrollment: 2464
Sex: ALL
Minimum age (years): 65
Standard ages: OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Step-wedge, open label, cluster randomized controlled trial with 1 year follow up. Area home care teams from three Danish municipalities are randomized to cross-over from the control phase to the intervention phase. Participants automatically follow their area home care team into the allocated group.
Primary purpose: PREVENTION

Brief summary: Utilization of public health care mirrors the older individual's overall health, and increased need for health care may precede more clear symptoms of acute disease. In a previous retrospective study, we found a significant increase in municipal home care service (minutes/week) in a 12-month period prior to acute hospitalization. This PhD-study aims at examining the effect of a software algorithm monitoring older citizens utilization of municipal home care. When home care increases the community nurse is notified and special attention is paid to the individual's current health situation. Pro-active health care initiatives may be launched in collaboration with the primary care physician. The intervention is the algorithm.


Eligibility criteria: Inclusion Criteria:

* Community dwelling citizens (+ 65) receiving home and social care in Odense, Kerteminde and Svendborg Municipalities.

Exclusion Criteria:

* Non

Primary outcomes:
measure: Hospitalizations
timeFrame: 30 days from identification by the algorithm (6 months for intervention phase)
Secondary outcomes:
measure: Hospital readmissions
timeFrame: 30 days from identification by the algorithm (6 months for intervention phase)
measure: Outpatient contacts
timeFrame: 30 days from identification by the algorithm (6 months for intervention phase)
measure: Use of temporary care in a skilled nursing facility
timeFrame: 30 days from identification by the algorithm (6 months for intervention phase)
measure: Use of community home and social care services
timeFrame: 30 days from identification by the algorithm (6 months for intervention phase)
measure: Contacts to primary care physicians
timeFrame: 30 days from identification by the algorithm (6 months for intervention phase)
measure: Mortality
timeFrame: 30 days from identification by the algorithm (6 months for intervention phase)
Other outcomes:
measure: Barriers and facilitators for nurse's acceptance of using the algorithm
timeFrame: 30 days from identification by the algorithm (6 months for intervention phase)
measure: Health economic analysis
timeFrame: 1 year
Locations:
city: Odense
country: Denmark
facility: Odense University Hospital
Study officials:
affiliation: Region of Southern Denmark
name: Anders Fournaise, MSPH
role: PRINCIPAL_INVESTIGATOR
References:
citation: Fournaise A, Lauridsen JT, Bech M, Wiil UK, Rasmussen JB, Kidholm K, Espersen K, Andersen-Ranberg K. Prevention of AcuTe admIssioN algorithm (PATINA): study protocol of a stepped wedge randomized controlled trial. BMC Geriatr. 2021 Feb 27;21(1):146. doi: 10.1186/s12877-021-02092-2.