Evaluating Novel Healthcare Approaches to Nurturing and Caring for Hospitalized Elders

NCT ID: NCT05929703

Last Updated: 2025-03-26

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

RECRUITING

Clinical Phase

NA

Total Enrollment

3000 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-12-04

Study Completion Date

2027-08-31

Brief Summary

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The goal of this clinical trial is to compare the Hospital Elder Life Program (HELP) with a family-augmented version of HELP (FAM-HELP), that includes family members and care partners, for the prevention of delirium in older patients during hospital admission. The main objectives of the trial are the following:

1. To compare the effectiveness of FAM-HELP and HELP in reducing both the incidence of delirium and its severity.
2. To compare the effectiveness of FAM-HELP and HELP in improving patient- and family-reported outcomes.
3. To explore the implementation context, process, and outcomes of the FAM-HELP program in diverse hospital settings.

Detailed Description

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Delirium is a common complication of hospitalization and major surgery for older adults, and it can lead to loss of independence and substantial healthcare costs. One approach to preventing delirium is through the Hospital Elder Life Program (HELP). HELP personnel work to prevent delirium by providing orienting communication, assisting patients with walking and exercise, providing help with nutrition and fluids, implementing sleep protocols, and helping patients with vision and hearing aids.

However, it is unknown whether involving family members in these activities along with HELP staff (i.e., "FAM-HELP") might be more effective with preventing delirium. The objective of this clinical trial is thus to compare the traditional HELP program with a family-augmented version of HELP (FAM-HELP) to determine which program is more effective with preventing delirium and related complications in older, hospitalized patients.

Conditions

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Delirium Neurocognitive Disorders Mild Cognitive Impairment Alzheimer Disease Aging Family Support Family Members Caregiver Burden Implementation Science Patient Satisfaction

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Stepped-wedge, cluster randomized
Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Investigators Outcome Assessors

Study Groups

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Hospital Elder Life Program (HELP)

Hospital Elder Life Program (HELP) is built upon multicomponent, non-pharmacologic strategies that target delirium risk factors to optimize cognitive and clinical function during hospitalization.

Group Type ACTIVE_COMPARATOR

HELP

Intervention Type BEHAVIORAL

This is usual (standard) care across hospitals in this trial. A multidisciplinary team of nurse specialists, social workers, and volunteers implement daily protocols focused on orientation, cognitive stimulation, early mobilization, sleep enhancement, support with visual and hearing aids, mealtime assistance, hydration, reduction in polypharmacy, and nursing-based delirium prevention protocols.

Family-Augmented Hospital Elder Life Program (FAM-HELP)

The FAM-HELP program will incorporate a family member and/or care partner, who will play a central role with providing bedside support for delirium risk reduction. Family members and care partners will provide social and emotional support along with augmentation of HELP-based protocols.

Group Type ACTIVE_COMPARATOR

FAM-HELP

Intervention Type BEHAVIORAL

Family members and care partners will provide daily emotional and social support during hospitalization. Additionally, family members and care partners will engage in HELP-based protocols throughout the day. The rationale for this protocol augmentation is two-fold: (1) HELP may not consistently have available volunteers (e.g., short-staffing) during a hospital stay, and (2) patients may be more likely to engage in therapeutic activities with a family member given the connection and comfort level.

Interventions

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HELP

This is usual (standard) care across hospitals in this trial. A multidisciplinary team of nurse specialists, social workers, and volunteers implement daily protocols focused on orientation, cognitive stimulation, early mobilization, sleep enhancement, support with visual and hearing aids, mealtime assistance, hydration, reduction in polypharmacy, and nursing-based delirium prevention protocols.

Intervention Type BEHAVIORAL

FAM-HELP

Family members and care partners will provide daily emotional and social support during hospitalization. Additionally, family members and care partners will engage in HELP-based protocols throughout the day. The rationale for this protocol augmentation is two-fold: (1) HELP may not consistently have available volunteers (e.g., short-staffing) during a hospital stay, and (2) patients may be more likely to engage in therapeutic activities with a family member given the connection and comfort level.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Provision of informed consent
* At least 70 years of age
* Anticipated length of hospital stay at least 72 hours
* Family member or care partner available to be on-site in the hospital
* At least one delirium risk factor (e.g., cognitive or functional impairment, dehydration, vision or hearing impairment)
* Evaluable cognitive function at baseline (i.e., ability to complete baseline cognitive function assessment)

Exclusion Criteria

* Delirium on admission
* Unable to communicate verbally (e.g., coma, mechanical ventilation)
* Unable to participate fully in interventions (e.g., terminal condition, advanced dementia)
* Staff safety concerns (e.g., violent behavior)
* Cardiac or intracranial surgery (due to competing causes of delirium)
Minimum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hebrew SeniorLife

OTHER

Sponsor Role collaborator

MaineHealth

OTHER

Sponsor Role collaborator

University of Pennsylvania

OTHER

Sponsor Role collaborator

West Penn Allegheny Health System

OTHER

Sponsor Role collaborator

UnityPoint Health - Meriter Hospital

UNKNOWN

Sponsor Role collaborator

University of Utah

OTHER

Sponsor Role collaborator

MemorialCare Saddleback Medical Center

UNKNOWN

Sponsor Role collaborator

Brandeis University

OTHER

Sponsor Role collaborator

Indiana University

OTHER

Sponsor Role collaborator

Patient-Centered Outcomes Research Institute

OTHER

Sponsor Role collaborator

University of Michigan

OTHER

Sponsor Role lead

Responsible Party

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Phillip Vlisides

Assistant Professor of Anesthesiology; Executive Director, Neuroscience Research

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Sharon K Inouye, MD

Role: PRINCIPAL_INVESTIGATOR

Hebrew SeniorLife

Phillip E Vlisides, MD

Role: PRINCIPAL_INVESTIGATOR

University of Michigan

Locations

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Saddleback Medical Center

Orange, California, United States

Site Status RECRUITING

MaineHealth

Portland, Maine, United States

Site Status RECRUITING

Michigan Medicine

Ann Arbor, Michigan, United States

Site Status RECRUITING

Hospital of the University of Pennsylvania

Philadelphia, Pennsylvania, United States

Site Status RECRUITING

Allegheny General Hospital

Pittsburgh, Pennsylvania, United States

Site Status RECRUITING

University of Utah

Salt Lake City, Utah, United States

Site Status RECRUITING

Meriter Hospital

Madison, Wisconsin, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Eva Schmitt, PhD

Role: CONTACT

617-971-5390

Facility Contacts

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Jessica Dela Rosa, MSN, MBA

Role: primary

(949) 607- 6030

Emily Carter, MD

Role: primary

207-662-3157

Jocelyn Wiggins, MD

Role: primary

734-647-7299

Shenbagam Dewar, MBBS

Role: backup

734-647-7299

Rebecca Trotta, PhD

Role: primary

215-615-4925

Lyn Weinberg, MD

Role: primary

412-235-5810

Mark Supiano, MD

Role: primary

801-587-9103

Carrie Bennett, DNP

Role: primary

(608) 417-5724

Other Identifiers

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DE-2022C1-25666

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

HUM00227397

Identifier Type: -

Identifier Source: org_study_id

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