Trial Outcomes & Findings for Implementation of Multidisciplinary Assessments for Geriatric Patients in an ED Observation Unit (NCT NCT04068311)

NCT ID: NCT04068311

Last Updated: 2026-01-09

Results Overview

The Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health Scale v1.2 is a 10-item patient-reported questionnaire assessing overall health and well-being. It provides two summary scores: Global Physical Health and Global Mental Health. Each of the two scores are standardized to the general US population, with a mean of 50 and a standard deviation of 10. Higher scores indicate better physical or mental health. This measure is reported in raw scores of 4 to 20 (range), with T scores of 16.2 - 67.7.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

373 participants

Primary outcome timeframe

90 days

Results posted on

2026-01-09

Participant Flow

Recruitment for the pre-implementation cohort occurred Sep 2019 - Nov 2020. Recruitment was terminated early due to external pressures \[we were at risk of losing accreditation as a Level 1 Geriatric emergency department if we did not show progress\]. Implementation roll out was paused until March 2021 due to the COVID-19 pandemic. The implementation period was March 2021-August 2022. The post-implementation cohort enrolled from Sep 2022-Aug 2023.

Participant milestones

Participant milestones
Measure
Pre-Implementation Cohort
Cohort of participants enrolled prior to the implementation of geriatric screening throughout the Emergency Department
Post-Implementation Cohort
A cohort of participants enrolled after geriatric screening was implemented in the Emergency Department
Overall Study
STARTED
143
230
Overall Study
Recruited
143
230
Overall Study
Analysis set
138
230
Overall Study
COMPLETED
111
159
Overall Study
NOT COMPLETED
32
71

Reasons for withdrawal

Reasons for withdrawal
Measure
Pre-Implementation Cohort
Cohort of participants enrolled prior to the implementation of geriatric screening throughout the Emergency Department
Post-Implementation Cohort
A cohort of participants enrolled after geriatric screening was implemented in the Emergency Department
Overall Study
Death
3
3
Overall Study
Lost to Follow-up
24
68
Overall Study
Withdrawal by Subject
5
0

Baseline Characteristics

Implementation of Multidisciplinary Assessments for Geriatric Patients in an ED Observation Unit

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Pre-Implementation Cohort
n=138 Participants
Cohort of participants enrolled prior to the implementation of geriatric screening throughout the Emergency Department
Post-Implementation Cohort
n=230 Participants
A cohort of participants enrolled after geriatric screening was implemented in the Emergency Department
Total
n=368 Participants
Total of all reporting groups
Age, Continuous
73.4 years
STANDARD_DEVIATION 6.5 • n=8 Participants
73.2 years
STANDARD_DEVIATION 6.4 • n=7 Participants
73.3 years
STANDARD_DEVIATION 6.4 • n=15 Participants
Sex: Female, Male
Female
67 Participants
n=8 Participants
120 Participants
n=7 Participants
187 Participants
n=15 Participants
Sex: Female, Male
Male
71 Participants
n=8 Participants
110 Participants
n=7 Participants
181 Participants
n=15 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
2 Participants
n=8 Participants
1 Participants
n=7 Participants
3 Participants
n=15 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
136 Participants
n=8 Participants
229 Participants
n=7 Participants
365 Participants
n=15 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=8 Participants
0 Participants
n=7 Participants
0 Participants
n=15 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=8 Participants
0 Participants
n=7 Participants
0 Participants
n=15 Participants
Race (NIH/OMB)
Asian
2 Participants
n=8 Participants
1 Participants
n=7 Participants
3 Participants
n=15 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=8 Participants
1 Participants
n=7 Participants
1 Participants
n=15 Participants
Race (NIH/OMB)
Black or African American
18 Participants
n=8 Participants
28 Participants
n=7 Participants
46 Participants
n=15 Participants
Race (NIH/OMB)
White
114 Participants
n=8 Participants
196 Participants
n=7 Participants
310 Participants
n=15 Participants
Race (NIH/OMB)
More than one race
1 Participants
n=8 Participants
1 Participants
n=7 Participants
2 Participants
n=15 Participants
Race (NIH/OMB)
Unknown or Not Reported
3 Participants
n=8 Participants
3 Participants
n=7 Participants
6 Participants
n=15 Participants
Charlson Comorbidity Index
5.2 units on a scale
STANDARD_DEVIATION 2.65 • n=8 Participants
4.79 units on a scale
STANDARD_DEVIATION 2.06 • n=7 Participants
4.9 units on a scale
STANDARD_DEVIATION 2.3 • n=15 Participants
Global Physical Health Quality of Life score (PROMIS)
43.9 T score
STANDARD_DEVIATION 8.4 • n=8 Participants
45.1 T score
STANDARD_DEVIATION 8.4 • n=7 Participants
44.6 T score
STANDARD_DEVIATION 8.4 • n=15 Participants
Global Mental Health Quality of Life score (PROMIS)
49.6 T score
STANDARD_DEVIATION 8.0 • n=8 Participants
50.8 T score
STANDARD_DEVIATION 8.1 • n=7 Participants
50.4 T score
STANDARD_DEVIATION 8.1 • n=15 Participants

PRIMARY outcome

Timeframe: 90 days

Population: Change in HRQoL at 90 days was obtained by subtracting the t-score from day 0 to day 90 for each participant and comparing both cohorts. Therefore we changed the t scores to a delta in scores and report mean and standard deviation of the change.

The Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health Scale v1.2 is a 10-item patient-reported questionnaire assessing overall health and well-being. It provides two summary scores: Global Physical Health and Global Mental Health. Each of the two scores are standardized to the general US population, with a mean of 50 and a standard deviation of 10. Higher scores indicate better physical or mental health. This measure is reported in raw scores of 4 to 20 (range), with T scores of 16.2 - 67.7.

Outcome measures

Outcome measures
Measure
Pre-Implementation Cohort
n=111 Participants
Cohort of participants enrolled prior to the implementation of geriatric screening throughout the Emergency Department
Post-Implementation Cohort
n=161 Participants
A cohort of participants enrolled after geriatric screening was implemented in the Emergency Department
Health Related Quality of Life (HRQoL) Using the Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health Scale v1.2
-0.73 T score
Standard Deviation 6.98
-0.33 T score
Standard Deviation 5.46

SECONDARY outcome

Timeframe: 90 days

Population: We defined a significant decline in Functional Status (OARS) as decrease of 3 or more points from day 0 to day 90. Comparisons between the pre and post cohorts were done using either Chi-square tests for proportions. A multivariable logistic regression model was planned to compare outcomes between the groups while controlling for any significant factors varying between the two cohorts, but was not able to be done due to the low number of primary outcome events.

We report the number of participants with a decrease of 3 points or more, our definition of functional decline. The OARS: Older Americans Resources and Services Program Activities of Daily Living Score ranges from 0-28, with higher scores representing worsening functional status. A change of 3 points is considered clinically significant functional decline.

Outcome measures

Outcome measures
Measure
Pre-Implementation Cohort
n=111 Participants
Cohort of participants enrolled prior to the implementation of geriatric screening throughout the Emergency Department
Post-Implementation Cohort
n=159 Participants
A cohort of participants enrolled after geriatric screening was implemented in the Emergency Department
Functional Status Using OARS: Older Americans Resources and Services Program Activities of Daily Living, Independent Activities of Daily Living Summary Scale
4 Participants
5 Participants

SECONDARY outcome

Timeframe: 90 days

Numerical tally of the outcomes of multidisciplinary geriatric assessment- arrangement for new home resources such as medical equipment and mobility equipment, new services such as home health, and new diagnoses of geriatrics syndromes.

Outcome measures

Outcome measures
Measure
Pre-Implementation Cohort
n=138 Participants
Cohort of participants enrolled prior to the implementation of geriatric screening throughout the Emergency Department
Post-Implementation Cohort
n=230 Participants
A cohort of participants enrolled after geriatric screening was implemented in the Emergency Department
Number of Participants Who Received Home Resources, Services and/or New Diagnoses of Geriatric Syndromes
33 Participants
67 Participants

SECONDARY outcome

Timeframe: 90 days

Percentage of older adults in the Emergency Department who are screened for geriatric syndromes with the Identifying Seniors at Risk tool, the brief delirium triage screen, and the 4 Stage Balance Test

Outcome measures

Outcome measures
Measure
Pre-Implementation Cohort
n=138 Participants
Cohort of participants enrolled prior to the implementation of geriatric screening throughout the Emergency Department
Post-Implementation Cohort
n=230 Participants
A cohort of participants enrolled after geriatric screening was implemented in the Emergency Department
Geriatric Screening Rates
17 Participants
210 Participants

Adverse Events

Pre-Implementation Cohort

Serious events: 0 serious events
Other events: 0 other events
Deaths: 3 deaths

Post-Implementation Cohort

Serious events: 0 serious events
Other events: 0 other events
Deaths: 3 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Lauren Southerland, Principal Investigator

The Ohio State University

Phone: 919-293-8305

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place