Protocol for Multi-site Evaluation of New Community-based Frailty Programme

NCT ID: NCT04866316

Last Updated: 2023-02-21

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 335 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2019-04-01
• Study Completion Date: 2022-09-30

Brief Summary

Background: Frailty is increasing in prevalence internationally with population ageing. Frailty can be managed or even reversed through community-based interventions delivered by a multi-disciplinary team of professionals, but to varying degrees of effectiveness. However, many of the implementation insights of these care models are contextual, and may not be applicable in different cultural contexts. The Geriatric Service Hub (GSH) is a novel frailty care programme in Singapore, that includes key components of frailty care such as comprehensive geriatric assessments, care coordination and the assembly of a multidisciplinary team. The aim of this study is to gain insights on the factors influencing the implementation approaches adopted by five participating sites, and the effectiveness of the programme.

Methods: We will adopt a mixed-methods approach that includes a qualitative evaluation among key stakeholders and participants taking part in the programme, through in depth-interviews and focus group discussions. The main topics covered includes factors that affected the development and implementation of each programme, operations and other contextual factors that influenced implementation outcomes. The quantitative evaluation (1) monitors each programme's care process through quality indicators, (2) a multiple-time point survey study to compare programme participants' pre- and post- outcomes on patient engagement (collaboRATE and 13-item Patient Activation Measure;PAM), healthcare experiences (Consumer Assessment of Healthcare Providers and System Clinician and Group Survey Version 3.0; CG-CAHPS), health status and quality of life (Barthel Index of Activities of Daily Living, fall counts, the EuroQol questionnaire and the Control, Autonomy, Self-realization and Pleasure scale; CASP-19), impact on caregivers (Zarit Burden Interview) and societal costs (Client Service Receipt Inventory). (3) A retrospective cohort design to assess healthcare and cost utilisation between participants of the programme and a propensity score matched comparator group.

Discussion: The GSH sites share a common goal to increasing accessibility of essential services to frail older adults, and providing comprehensive care. The results of this evaluation study will provide valuable evidence to the impact and effectiveness of the GSH, and inform to the design of similar programmes targeting frail older adults.

Conditions

Frailty; Frail Elderly Syndrome; Frailty Syndrome

Study Design

• Observational Model Type: OTHER
• Study Time Perspective: PROSPECTIVE

Study Groups

GSH Participants

Qualitative - Semi-structured focus group discussions with care recipients

Quantitative - Pre-test post-test design using survey-based data collection

Quantitative - Retrospective cohort design with propensity score matched comparators

There is no active intervention as this is a service evaluation

Intervention Type: OTHER

There is no active intervention as this is a service evaluation

Policy owners, implementers & care partners, health and social care professionals

Qualitative - Semi-structured in-depth interview with key policy and programme decision-makers

Qualitative - Semi-structured focus group discussions with health and social care professionals

Qualitative - Participant observations

Quantitative - Longitudinal monitoring of process indicators

There is no active intervention as this is a service evaluation

Intervention Type: OTHER

There is no active intervention as this is a service evaluation

Interventions

There is no active intervention as this is a service evaluation

There is no active intervention as this is a service evaluation

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Decision-makers who are higher-level administrators or clinicians who have the authority to make policy and implementation decisions and/ or
• Individuals who are familiar with the hospital's overall frailty strategy; and/ or
• Individuals that who led the development and implementation of the programme

2. Qualitative Focus group discussions/ Implementation team

• Individuals with time funded through the programme who have been providing services in the GSH for at least six month

3. Qualitative Focus group discussions/ partner organizations

• healthcare professionals and administrative staff who provided services within the new programme for at least six months

4. Qualitative Focus group discussions/ GSH participants

• Participants who receive care under the new model for at least three months

5. Quantitative survey questionnaire / GSH participants

• Patients that meet the necessary clinical criteria for enrollment in the respective GSH programme
• Age: 65 and above
• Clinical Frailty Score (CFS): 4-7

• Minimum Eligible Age: 21 Years
• Maximum Eligible Age: 99 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Alexandra Hospital

OTHER

Sponsor Role: collaborator

Changi General Hospital

OTHER

Sponsor Role: collaborator

Ng Teng Fong General Hospital

OTHER

Sponsor Role: collaborator

Sengkang General Hospital

OTHER

Sponsor Role: collaborator

Singapore General Hospital

OTHER

Sponsor Role: collaborator

Geriatric Education and Research Institute

OTHER_GOV

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Woan Shin Tan, PhD

Role: PRINCIPAL_INVESTIGATOR

Joint Faculty and PI

Locations

Geriatric Education and Research Institite

Singapore, , Singapore

Countries

Singapore

References

Tan WS, Nai ZL, Tan HTR, Nicholas S, Choo R, Ginting ML, Tan E, Teng PHJ, Lim WS, Wong CH, Ding YY; Geriatric Services Hub Programme Group. Protocol for a mixed-methods and multi-site assessment of the implementation process and outcomes of a new community-based frailty programme. BMC Geriatr. 2022 Jul 15;22(1):586. doi: 10.1186/s12877-022-03254-6.

Reference Type: DERIVED

PMID: 35840898 (View on PubMed)

Provided Documents

Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

2019/00925

Identifier Type: -

Identifier Source: org_study_id