Clinical Trial Details
— Status: Active, not recruiting
Administrative data
NCT number |
NCT04235738 |
Other study ID # |
2020-2184 |
Secondary ID |
|
Status |
Active, not recruiting |
Phase |
|
First received |
|
Last updated |
|
Start date |
January 17, 2020 |
Est. completion date |
February 1, 2025 |
Study information
Verified date |
February 2024 |
Source |
Jewish General Hospital |
Contact |
n/a |
Is FDA regulated |
No |
Health authority |
|
Study type |
Observational
|
Clinical Trial Summary
This study examines the prevalence and incidence of older ER users with cognitive impairment
(i.e., dementia and/or delirium) using the ER2 item temporal disorientation in older ED users
who are participants of the ER2 cohort study database.
Description:
The Emergency Departments (EDs) in North America are under duress because of overcrowding,
delays and diversions, which increase to epidemic proportions. The aging of Canadian's
population amplifies the magnitude of this situation because older ED users are the fastest
increasing group of ED users and they have complex and specific needs.
There are simple interventions with which providers must proceed in order to cure or prevent
short-term ED adverse events. Delirium, motor deconditioning, polypharmacy-related adverse
drug reactions, and inappropriate home support are the main conditions to target when taking
care of older ED users. We previously demonstrated that acting on these conditions may
significantly accelerate the discharge and significantly reduce the length of ED and hospital
stay. Evidence-based medicine showed that simple and early interventions may prevent delirium
(e.g., through hydration, avoiding restraint, mobilizing and satisfying basic needs, time and
place reorientation) and motor deconditioning (e.g., through encouraging mobility, up to
chair at mealtime during daytime hours, providing appropriate walking aid) in older patients.
Medication reconciliation is also an efficient intervention to prevent adverse drug
reactions. Furthermore, an early assessment of home support is a crucial step in adjusting
services for an early and smooth discharge back home. Based on this evidence, we have
modified the 6-item Emergency Room Evaluation and Recommendations (ER2) by adding an
interventional component to the assessment portion of the tool. The interventional part
depends on the assessment's results and is based on recommendations designed to encourage
easy and basic interventions that prevent delirium, motor deconditioning, adverse drug
interactions and inappropriate home support. These recommendations are based on answers to
the ER2 items