The CareWell-programme for Community-dwelling Frail Elderly Persons.

Overview

The purpose of this study is to investigate the effect of the CareWell-programme on overall functioning of community-dwelling frail elderly persons. Furthermore, the total costs and the cost-effectiveness of the CareWell-programme, in comparison with regular medical care, will be studied.

Full Title of Study: “Towards a CARE AND WELFARE STANDARD for Community-dwelling Frail Elderly People With Complex Health Problems”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Non-Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Health Services Research
    • Masking: None (Open Label)
  • Study Primary Completion Date: January 2013

Interventions

  • Other: The CareWell programme
    • The CareWell programme contains the following components: multidisciplinary primary care teams working with proactive care plans integrating cure, care and welfare advanced care planning (e.g. recording limitations of treatment, non-resuscitation decisions) medication review case-management guidelines for consultation of in-hospital geriatric experts guidelines for transfers from primary care to home-based facilities and hospital and back practice guidelines for management of common geriatric conditions

Arms, Groups and Cohorts

  • No Intervention: regular medical care
    • Identified community dwelling frail elderly people receiving regular medical care in their primary care setting
  • Experimental: The CareWell programme
    • Identified community dwelling frail elderly people receiving care in line with the CareWell programme

Clinical Trial Outcome Measures

Primary Measures

  • Overall functioning
    • Time Frame: 18 months
    • Overall functioning is measured with the Katz-15 questionnaire. Katz-15 is embedded in the minimal data set (MDS). This MDS is used by all research projects of the Dutch National Program on Elderly Care
  • Incremental cost-effectiveness ratio (ICER)
    • Time Frame: 18 months

Secondary Measures

  • Perceived quality of life
    • Time Frame: 18 months
    • Perceived quality of life is measured with the RAND-36 questionnaire. RAND-36 is embedded in the minimal data set (MDS). This MDS is used by all research projects of the Dutch National Program on Elderly Care
  • Psychological well-being
    • Time Frame: 18 months
    • Psychological well-being is measured with the RAND-36 questionnaire.
  • Social functioning
    • Time Frame: 18 months
    • Social functioning is measured with the RAND-36 questionnaire.
  • Perceived health
    • Time Frame: 18 months
    • Perceived health is measured with the RAND-36 questionnaire abd Cantril’s Self Anchoring Ladder. Both RAND-36 as Cantril’s Self Anchoring Ladder are embedded in the minimal data set (MDS).
  • Utility
    • Time Frame: 18 months
    • Utility is measured with the EQ-5D questionnaire. EQ-5D is embedded in the minimal data set (MDS).
  • Health care consumption
    • Time Frame: 18 months
    • Health care consumption including hospital resource consumption, unplanned GP care (evenings, nights and weekends), home care, temporary or permanent admission to a residential care home, temporary or permanent admission to a nursing home, day care, visits to outpatients’clinics.
  • Use of welfare services
    • Time Frame: 18 months

Participating in This Clinical Trial

Inclusion Criteria

  • Frail community dwelling elderly patients aged 70 years or above. Frailty is determined with a two-phase screening instrument. Exclusion Criteria:
  • Non-frail elders – Patients in palliative or end-of-life stages of disease – Patients residing in long-term care facilities (care homes and nursing homes) – Patients already enrolled in specific dementia-related case-management programmes who lack other health-related problems – Patients not speaking or understanding the Dutch language
  • Gender Eligibility: All

    Minimum Age: 70 Years

    Maximum Age: N/A

    Are Healthy Volunteers Accepted: No

    Investigator Details

    • Lead Sponsor
      • Radboud University
    • Collaborator
      • ZonMw: The Netherlands Organisation for Health Research and Development
    • Provider of Information About this Clinical Study
      • Sponsor
    • Overall Official(s)
      • Raymond Koopmans, Professor, Principal Investigator, Radboud University

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