Interprofessional Preoperative Geriatric Assessment for Older Arthroplasty Patients With Multimorbidity

NCT ID: NCT04001699

Last Updated: 2019-06-28

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

140 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-08-19

Study Completion Date

2024-12-31

Brief Summary

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The objective of this randomized control trial is to investigate effects and cost effectiveness of interprofessional preoperative assessment among older knee or hip arthroplasty patients. The main hypothesis is that preoperative assessment and optimization have a positive impact on the patents' quality of life and expenditure of social and health care services.

Detailed Description

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Knee and hip arthrosis are common conditions among older adults. Progression of arthrosis often leads to worsening of symptoms and decreased mobility, daily functioning and quality of life. Total joint arthroplasty improves pain in end-stage arthrosis but accustomed postoperative care and rehabilitation alone may not guarantee optimal regain of functioning for frail and vulnerable older arthroplasty patients. Preoperative optimization of older patients with multimorbidity and functional limitations may improve benefits of the arthroplasty even at lower costs. Patients randomized into intervention arm of the present study receive preoperative assessment with treatment and prehabilitation plan. The focuses of the intervention are patient's chronic conditions, nutritional status, medication and physical activity. The intervention is delivered by multiprofessional team (geriatrician, registered nurse, physiotherapist and pharmacist).

Older adults undergoing surgery are a rapidly growing but vulnerable patient group. Knowledge on effects of preoperative evaluation and optimization is sparse, especially on the effects of multi-domain interventions.

Conditions

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Multimorbidity Knee Arthrosis Hip Arthrosis

Keywords

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preoperative geriatric assessment interprofessional team

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Intervention

Preoperative assessment conducted by an interprofessional team

Group Type EXPERIMENTAL

Preoperative geriatric assessment

Intervention Type OTHER

In addition to the usual care, patients randomized to the intervention group receive preoperative assessment conducted by an interprofessional team including geriatrician, registered nurse, physiotherapist and pharmacist. Based on the assessment, a preoperative optimization plan is constructed focusing on the treatment of the patient's chronic conditions, nutritional status, medication and physical activity.

Usual care

Usual care

Group Type ACTIVE_COMPARATOR

Preoperative geriatric assessment

Intervention Type OTHER

In addition to the usual care, patients randomized to the intervention group receive preoperative assessment conducted by an interprofessional team including geriatrician, registered nurse, physiotherapist and pharmacist. Based on the assessment, a preoperative optimization plan is constructed focusing on the treatment of the patient's chronic conditions, nutritional status, medication and physical activity.

Interventions

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Preoperative geriatric assessment

In addition to the usual care, patients randomized to the intervention group receive preoperative assessment conducted by an interprofessional team including geriatrician, registered nurse, physiotherapist and pharmacist. Based on the assessment, a preoperative optimization plan is constructed focusing on the treatment of the patient's chronic conditions, nutritional status, medication and physical activity.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Place of residence: Kuopio or Vesanto municipality
* Age ≥ 65 years
* Clinical decision for knee or hip arthroplasty, elective operation with more than one month waiting time, primary arthroplasty of the index joint.
* Multimorbidity: the patient has at least two chronic diseases with potential to affect functioning, diseases are defined according to the Function Comorbidity Index (FCI)


* 5 or more medicines taken regularly (polypharmacy)
* continuous walking distance less than 500 m
* needs help in dressing and/or washing oneself
* needs help when visiting or taking care of businesses outside home
* body mass index ≤ 23 or ≥ 34
Minimum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Kuopio University Hospital

OTHER

Sponsor Role collaborator

University of Eastern Finland

OTHER

Sponsor Role lead

Responsible Party

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Eija Lönnroos

professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Eija Lönnroos

Role: PRINCIPAL_INVESTIGATOR

University of Eastern Finland, Institute of Public Health and Clinical Nutrition

Locations

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University of Eastern Finland

Kuopio, , Finland

Site Status

Countries

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Finland

Central Contacts

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Eija Lönnroos, MD, PhD

Role: CONTACT

Phone: +358 40 3552932

Email: [email protected]

Kaisa Haatainen

Role: CONTACT

Email: [email protected]

Facility Contacts

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Eija Lönnroos, MD, PhD

Role: primary

Kaisa Haatainen, PhD

Role: backup

Other Identifiers

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HERIT

Identifier Type: -

Identifier Source: org_study_id