A Geriatric Mobile Team for Nursing Home Residents: a Feasibility Pilot Study

Официальное название

A Geriatric Mobile Team for Nursing Home Residents: an Exploratory, Prospective, Single-Center, Non-Randomized, Non-Interventional Feasibility Pilot Study

Обзор

Nursing home (NH) residents have complex healthcare needs. Barriers to collaboration hinder the delivery of high-quality care in nursing homes. To bridge the gap between hospital-based and NH-based care, various innovative approaches have been proposed, including geriatric mobile teams. In Belgium, geriatric expertise has long been confined to hospital settings. Until recently, no specific organization existed for outpatient geriatric assessment, particularly for NH residents. In April 2024, the National Institute for Health and Disability Insurance (INAMI) introduced a new reimbursement code for geriatric consultations in NHs, promoting the development of extramural geriatric activities. However, evidence on the effectiveness of mobile geriatric teams remains limited, particularly regarding hospitalization prevention. The geriatrics department of CHU UCL Namur is implementing a one-year pilot project involving a mobile team composed of a geriatrician and a nurse to conduct geriatric assessments in the three nursing homes. This non-randomized pilot project aims to establish a new standard of care for residents selected by their general practitioner, leveraging the new reimbursement code. The project is accompanied by a clinical study assessing the feasibility, effectiveness, and acceptability of this intervention. Prospectively collected data will also help define key indicators for a future large-scale study focused on cost-effectiveness.

Вмешательства

• Другое Geriatric assessment
  The tertiary hospital's geriatrics department is implementing a one-year mobile team composed of a geriatrician and a nurse to conduct geriatric assessments (Anamnesis and heteroanamnesis - Clinical examination - Medication review - Proposed management plan provided to the general practionner, who independently decides which recommendations to implement) in three nursing homes. This non-randomized pilot project aims to establish a new standard of care for residents selected by their primary care

Первичные конечные точки

• Feasability [Срок оценки: Immediately after the initial consultation, with follow-up assessments at 3, 6, 9, and up to 12 months post-inclusion.]

Вторичные конечные точки (2)

• Acceptability [Срок оценки: Immediately after the initial consultation, with follow-up assessments at 3, 6, 9, and up to 12 months post-inclusion]
• Determine the outcomes for a future full evaluation study. [Срок оценки: Immediately after the initial consultation, with follow-up assessments at 3, 6, 9, and up to 12 months post-inclusion]

Критерии участия

Критерии включения

• Patients aged over 70 years
• Presenting with one or more of the following conditions:

• Difficulties in establishing an advance care planning
• Medical complexity (multiple specialists, repeated hospitalizations)
• Polypharmacy
• Recurrent falls
• Unmanageable behavioral disorders
• Weight loss
• Memory impairment

Критерии исключения

• Patients with an unstable medical condition requiring urgent care
• Patients under 70 years old
• Patients whose condition requires examinations or treatments available only in a hospital setting

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Модель наблюдения

Когортное

Центры проведения

Бельгия · 1 центр

• CHU UCL Namur — Yvoir

Идентификаторы

NCT: NCT06873919 · GerMoT · 40025834

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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