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Recruiting NCT07237334

A Prospective Cohort Study of Clinical and Process Outcomes of Older Adults That Transition Through the Geriatric Emergency Medicine Unit(GEM-U)

— Observational Frailty

For patients and families

In plain language

An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.

What is being studied
This is an observational study: the protocol does not assign a study treatment.
Who it may be relevant to
Registry conditions: Frailty. Basic parameters: from 75 years · All.
What needs checking
Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
Where it takes place
Ireland
Next step
Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →

Unsure about the terms? Read our patient guide →

Official title

A Prospective Cohort Study of the Clinical and Process Outcomes of Older Adults That Transition Through the Geriatric Emergency Medicine Unit (GEM-U)

Overview

This study will characterise the patients using the Geriatric Emergency Medicine Unit, a unit which provides specialist care for patients aged 75 years and older attending the emergency department. It will examine how this specialist care impacts their health in terms of a number of different outcomes, such as; function, quality of life and health care usage; for example admission to the acute hospital.

Detailed description

The emergency department is a particularly challenging and busy environment, particularly for older adults living with frailty. It is widely acknowledged throughout the literature and national healthcare strategy that these older adults require holistic, person centred care that targets the intricacies of multifaceted, complex health issues.

The geriatric emergency medicine unit (GEM-U) aims to provide such care through the framework of comprehensive geriatric assessment, with in-put from a team of healthcare disciplines. The main aim of this study is to look at how this specialist care impacts patient outcomes, such as acute admission. Clinical and process outcomes of participants will be examined using patient reported outcome measures, which will include;

1. Global measure of function (Barthel Index) 2. Delirium screen (4AT +/- Delirium Rating Scale)\* 3. Frailty status (Clinical Frailty Scale) 4. Nutritional status (Mini Nutritional Assesment) 5. Quality of life (EuroQoL-5D-5L). 6. Patient satisfaction (PSQ-18).

Participants will be followed at 30 days and 6 months post recruitment. All participants will give fully informed consent. The STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) standardised reporting guidelines will be followed in the conduct and reporting of this research. Data will be statistically analysed

Primary outcome measures

  • Our primary outcome is incidence of hospital admission at index GEM-U presentation [Time frame: Patients are followed at 30 days and 6 months]
Secondary outcome measures (5)
  • Mortality [Time frame: Patients are followed at 30 days and 6 months]
  • Unscheduled ED revisit [Time frame: Patients are followed at 30 days and 6 months]
  • Unscheduled hospital visit(s) [Time frame: Patients are followed at 30 days and 6 months]
  • Nursing home admission [Time frame: Patients are followed at 30 days and 6 months]
  • Healthcare utilization (GP visit, out-patient geriatric services, PHN visit, HSCP services) [Time frame: Patients are followed at 30 days and 6 months]

Eligibility criteria

Inclusion criteria

  • Older adults aged ≥75 years
  • Manchester Triage System category 2-5
  • Screen positive for risk of adverse outcomes after ED visit (≥ 2 on ISAR screening tool)
  • Presenting with a medical condition
  • Reviewed by the Older Persons Integrated Care Team

Exclusion criteria

  • Patients presenting with a non-medical issue including major trauma or hip fracture
  • Patients presenting with acute stroke or transient ischaemic attack
  • Patients more appropriate to another alternative pathway e.g. deep vein thrombosis pathway, low risk chest pain pathway
  • Patients with acute coronary syndrome or unstable arrthymia
  • Patients requiring care in the resuscitation room
  • Patients with head injury (unless appropriate assessment and management has been fully completed by ED team)
  • Patients with possible spinal injury (unless appropriate assessment and management has been fully completed by ED/orthopaedic team)
  • Patients with low Glasgow Coma Scale
  • Other exclusions at the discretion of the Older Persons Integrated Care team depending on team capacity and expertise
  • Exclusion criteria as set out above, are in line with those set out in the UHL Operating Policy of the Older Persons Integrated Care Team.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Observational model
Cohort

Study locations

Ireland · 1 center
  • University Hospital Limerick — Limerick

Identifiers

NCT: NCT07237334 · GEM-U2025

Primary sources (government registries)

View this study on ClinicalTrials.gov ↗