Aging Clinical Trial
Official title:
A Pragmatic Trial to Evaluate the Impact of Community-based Personalized Care on Quality of Life in Older and Disabled Adults
A pragmatic randomized trial to evaluate the impact of an integrated patient experience and
outcome measurement system supported by citizens, caregivers and community through eHealth
technology.
The primary research question is: What is the effectiveness of the WECCC approach on quality
of life in people aged 65 and older or who self-identify as disabled compared to people not
receiving the Health TAPESTRY program?
Secondary research questions include:
1. what is the feasibility of obtaining study measures through routinely collected program
participant data and what design adjustments are needed to balance pragmatism and high
quality data collection?
2. What are the analytic approaches to be developed to aggregate data from individual
participants into meaningful units (e.g. care-team level, organizational level, social
network, and geographic area) to inform ongoing adaptation of the components of the
intervention?
3. what are the perceptions of knowledge users on the usefulness of comparative
effectiveness pragmatic trial evidence?
The project involves using administrative data from the ICES to create outcome measures and
feedback systems for communities, and the INSPIRE PHC Unit for expertise in health system
integration, care in the community, and knowledge translation.
Inclusion criteria: Seniors (65+) and people who self-identify as having a functional
disability. Pilot study sites: 7 municipalities and the city of Windsor in Windsor-Essex
County in Ontario. The combined total eligible population in all 8 sites is about 60,000
people, from which a minimum sample of 3000 registered patients and 1000 registered
caregivers will be drawn
In Year 1, planned enrolment includes a minimum of 1100 intervention clients from all
recruitment methods in the care model intervention, with similar numbers of control and
intention to treat clients.
The primary outcomes are quality of life (QOL); perceived health; experience of care, and
perceived social connection.
The primary outcomes for caregivers will be quality of life; perceived burden; caregiver
perceptions of care; and perceived social connection.
Secondary outcomes for both will include goal attainment, distress management, symptom
management, places of care, and health care utilization and costs. In terms of health equity,
the investigators will measure the difference between the average/median population quality
of life and cost outcomes compared to patients at the bottom income quartiles stratified by
risk level. At a systems level, algorithms will be developed and applied to the data
collected from participants to provide aggregate organization and system-level reports,
co-designed with end users to support them as learning organizations.
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