Improving Decision Making On Location of Care With the Frail Elderly and Their Caregivers

NCT ID: NCT02244359

Last Updated: 2016-08-25

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

455 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-09-30

Study Completion Date

2016-08-31

Brief Summary

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One of the toughest decisions faced by the frail elderly in Canada is whether to stay at home or move to a care facility. It is certainly difficult to make this decision alone, but can be even harder if someone else makes it for you. Shared decision making is when, instead of making decisions for the patient, healthcare professionals share information about what the evidence says, and they talk about what's important with the patient, and then make the decision together. In the case of the frail elderly in home care services, there are many health care professionals involved, e.g. the doctor, nurse and social worker. In this case decisions should be shared by all the professionals involved with the elderly person along with his or her caregivers. Unfortunately, in this context, shared decision making rarely occurs.

We have designed a training program that teaches interprofessional teams how to share decisions with their frail elderly patients, and tested it in one Quebec City and one Edmonton home care team. This project tests the training program on a broader scale with 16 home care teams attached to community health centres across the province of Quebec, and will compare the results with what happens when no one has completed the training (usual care). Home care is a rapidly growing sector and this study will lay the foundations for a national strategy to ensure that no one has to make this difficult decision alone.

Detailed Description

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Conditions

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Decision Process About the Location of Care Among Frail Elderly

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

SINGLE

Participants

Study Groups

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Training

Online tutorial, decision aid and interactive workshop

Group Type EXPERIMENTAL

Training

Intervention Type BEHAVIORAL

Usual care

Usual care

Group Type OTHER

Usual care

Intervention Type BEHAVIORAL

Interventions

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Training

Intervention Type BEHAVIORAL

Usual care

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Receiving care from the home care team
* Faced the decision about whether to stay at home or move to a care facility in the previous 3 to 6 months
* Able to read, understand and write french or english
* Able to give informed consent
* For the case of clients unable to provide informed consent, their caregivers who was involved into decision making process will be eligible

Exclusion Criteria

* Clients who cannot provide informed consent (e. g. clients with cognitive impairment) without a caregiver
* Clients who require acute care hospitalization and whom the location of care decision is transferred to hospital-based social services
Minimum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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TVN 2013 Core Research Grant Program

UNKNOWN

Sponsor Role collaborator

Ministere de la Sante et des Services Sociaux

OTHER

Sponsor Role collaborator

Health and Social Services Agency, Montreal

OTHER

Sponsor Role collaborator

CHU de Quebec-Universite Laval

OTHER

Sponsor Role lead

Responsible Party

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France Legare

B. Sc. Arch, MD, PhD, CCMF, FCMF

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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France Légaré, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

CHUQ Research Center

Locations

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CHU de Québec

Québec, Quebec, Canada

Site Status

Countries

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Canada

References

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Adekpedjou R, Haesebaert J, Stacey D, Briere N, Freitas A, Rivest LP, Legare F. Variations in factors associated with healthcare providers' intention to engage in interprofessional shared decision making in home care: results of two cross-sectional surveys. BMC Health Serv Res. 2020 Mar 12;20(1):203. doi: 10.1186/s12913-020-5064-3.

Reference Type DERIVED
PMID: 32164669 (View on PubMed)

Boucher A, Haesebaert J, Freitas A, Adekpedjou R, Landry M, Bourassa H, Stacey D, Croteau J, Genevieve PG, Legare F. Time to move? Factors associated with burden of care among informal caregivers of cognitively impaired older people facing housing decisions: secondary analysis of a cluster randomized trial. BMC Geriatr. 2019 Sep 9;19(1):249. doi: 10.1186/s12877-019-1249-1.

Reference Type DERIVED
PMID: 31500590 (View on PubMed)

Garvelink MM, Emond J, Menear M, Briere N, Freitas A, Boland L, Perez MMB, Blair L, Stacey D, Legare F. Development of a decision guide to support the elderly in decision making about location of care: an iterative, user-centered design. Res Involv Engagem. 2016 Jul 19;2:26. doi: 10.1186/s40900-016-0040-0. eCollection 2016.

Reference Type DERIVED
PMID: 29062524 (View on PubMed)

Garvelink MM, Freitas A, Menear M, Briere N, Stacey D, Legare F. In for a penny, in for a pound: the effect of pre-engaging healthcare organizations on their subsequent participation in trials. BMC Res Notes. 2015 Dec 8;8:751. doi: 10.1186/s13104-015-1743-2.

Reference Type DERIVED
PMID: 26645477 (View on PubMed)

Legare F, Briere N, Stacey D, Bourassa H, Desroches S, Dumont S, Fraser K, Freitas A, Rivest LP, Roy L. Improving Decision making On Location of Care with the frail Elderly and their caregivers (the DOLCE study): study protocol for a cluster randomized controlled trial. Trials. 2015 Feb 12;16:50. doi: 10.1186/s13063-015-0567-7.

Reference Type DERIVED
PMID: 25881122 (View on PubMed)

Other Identifiers

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CORE 2013-56

Identifier Type: -

Identifier Source: org_study_id

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