Home-visits From geRiatric tEam aFter hIp fracTure

NCT ID: NCT04777136

Last Updated: 2022-05-20

Basic Information

• Recruitment Status: UNKNOWN
• Clinical Phase: NA
• Total Enrollment: 200 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2021-03-01
• Study Completion Date: 2023-02-28

Brief Summary

The primary objective is to examine the effect of multidisciplinary geriatric team home-visits as follow-up after a hip fracture in old patients. The hypothesis is that home-visits will reduce the number of falls, readmissions, prevent functional decline, optimize that medical treatment, and a higher degree of satisfaction and quality of life.

Detailed Description

Among older individuals, falling is a strong predictor of frailty, morbidity, and mortality and may cause a fracture. Many older patients experience recurrent falls, further functional decline, and readmission within the first three months. Hence, fall-related visits to the hospital represent a "red flag" but are also an opportunity for targeted intervention and prevention of future falls. However, many older patients are only treated for fall-related injuries and discharged without fall risk assessment or evaluation, hence there is a need for follow-up with targeted fall assessment and intervention to prevent further falls.

Thus, the present project aims to examine the effect of home-visit follow-up of older frail patients discharged from the orthopedic ward with a hip fracture. Furthermore, we will explore the effect of a cross-sectorial collaboration between hospital and municipality in the patients' homes to prevent falls, readmissions, medicine-associated adverse effects, and physical deconditioning in old frail patients.

The present study is a interventional trial. The intervention will consist of a home visit within ten weekdays of the discharge, where a comprehensive geriatric assessment (CGA) will be performed. The team performing the CGA consist of a Geriatrician and an experienced geriatric nurse. CGA is an overall assessment of the patient taking account of; the presence and severity of comorbidity, the nutritional state, cognitive and functional status, review of current medications, and social measures. The purpose is to stabilize and optimize current as well as chronic conditions, and reduce the probability of adverse events and falls, and to secure interventions or changes persist through the transition from the secondary to the primary health care system. The assessment may lead to several interventions, including; medicine review (new medicine, change in current or discontinuation), initiation of a nutritional effort or contact to a dietitian, referral to other health care services (outpatient clinics, hospitals, or general practitioner), referral to physiotherapy and/or occupational therapy or optimization of home care.

Patients randomized to the control group will receive standard care, where the subsequent need for medical service or increased home care will require contact with the general practitioner or the municipality, at the patient's initiative.

Conditions

Geriatric Assessment; Hip Fractures; Frailty; Old Age; Atrophy

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: PREVENTION
• Blinding Strategy: NONE

Study Groups

Geriatric home visit

Home-visit where a comprehensive geriatric assessment will be performed

Group Type: EXPERIMENTAL

Home visit and comprehensive geriatric assessment

Intervention Type: OTHER

Home-visit from the geriatric team, who will do a full geriatric assessment and targeted interventions

Standard care

No follow-up.

Group Type: ACTIVE_COMPARATOR

Control group, no designated follow up

Intervention Type: OTHER

Only follow-up on patients own initiative with contact to the general practitioner

Interventions

Home visit and comprehensive geriatric assessment

Home-visit from the geriatric team, who will do a full geriatric assessment and targeted interventions

Intervention Type: OTHER

Control group, no designated follow up

Only follow-up on patients own initiative with contact to the general practitioner

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Age of 70 years or older
• Hip fracture
• Ability to provide informed consent
• Residence in one of three following municipalities: Gladsaxe, Rudersdal or Lyngby-Taarbæk

Exclusion Criteria

• No ability to provide informed consent
• Patients, who dies within 48 hours of discharge
• Terminal patients

Nursing home residents

• Minimum Eligible Age: 70 Years
• Maximum Eligible Age: 120 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Herlev Hospital

OTHER

Sponsor Role: lead

Responsible Party

Martin Schultz

MD, PhD

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Herlev and Gentofte hospital

Herlev, Capital Region, Denmark

Countries

Denmark

Other Identifiers

HgH_UGT_01

Identifier Type: -

Identifier Source: org_study_id