Acute Illness Clinical Trial
Official title:
Advanced Use of Point-of-care Technology Versus Usual Care During In-home-assessment by Acute Community Nurses in Older Adults for Reducing Acute Hospital Admissions
Verified date | November 2023 |
Source | University of Southern Denmark |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
Due to ageing-related physiological changes, diagnosing older adults is challenging. Delayed disease recognition lead to adverse health outcomes and increased hospitalisation, which is why there is a need to develop new procedures for timely diagnosis and treatment of older adults. Point-of-care technology, e.g. focused lung ultrasound scan and bedside analysis of blood samples (leucocytes with differential count, electrolytes and creatinine) carried out in the patients' home may support clinical decision-making, and potentially reduce acute hospital admissions. The trial's overall aim is to investigate whether increased point-of-care technology, i.e. focused lung ultrasound scan and bedside blood analysis, used as in-home diagnostics in older adults with acute respiratory symptoms, can qualify the general practitioner's clinical decision-making for early treatment initiation and eventually reduce acute hospital admission.
Status | Completed |
Enrollment | 632 |
Est. completion date | November 18, 2023 |
Est. primary completion date | November 18, 2023 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 65 Years and older |
Eligibility | Inclusion Criteria: - referred to the ACHCS in Kolding Municipality for in-home assessment - dyspnoea - cough - fever - fall - functional decline defined as either subjective (not able to perform normal daily activities as usual) or objective functional decline (increased need of home care) Exclusion Criteria: - moderate to severe cognitive impairment - antibiotic treatment |
Country | Name | City | State |
---|---|---|---|
Denmark | Siri Smedemark | Kolding | Region Syddanmark |
Lead Sponsor | Collaborator |
---|---|
University of Southern Denmark | AP Moeller Foundation, Director Emil C Hertz and wife Inger Hertz Foundation, Gangsted Foundation, Hartmann Fonden, Karen Elise Jensen Foundation, Kolding Municipality, Denmark, Merchant L. F. Foghts Foundation, Odense Patient Data Explorative Network, Odense University Hospital, Region of Southern Denmark |
Denmark,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Other | The diagnostic accuracy of FLUS conducted by ACNs | ACNs conclusions are index test and FLUS-specialist conclusions used as reference test. | 7 days | |
Primary | Admission = 30-days | Proportion of Admissions during 30 days follow-up | 30 days | |
Secondary | Mortality = 30-days | Proportion of diseased participants in the intervention group and control group after inclusion during 30 days follow-up | 30 days | |
Secondary | Acute admissions at day 0 | Proportion of acute admissions on visit day (day 0) | Day 0 | |
Secondary | Length of hospital admission | Number of days admitted to acute-care hospital, long-term acute-care hospital or in an emergency department. | 30 days | |
Secondary | Hospital-free days = 30-days | Number of days alive that is spend outside of an acute-care hospital, long-term acute-care hospital or in an emergency department, including days spent wholly or in part under "observation" status | 30 days | |
Secondary | Complications during hospital admission | Number of complications registered in the electronic patient journal during admission including delirium and fall | 30 days | |
Secondary | Treatment initiations or changes at day 0 | Number of treatment initiation or changed at day 0 including antibiotics, diuretics, inhalation medication, prednisolone, iv fluids, iv antibiotics | Day 0 | |
Secondary | Treatment initiation or changes = 30-day | Number of treatment initiation or changed during 30 days follow-up including antibiotics, diuretics, inhalation medication, prednisolone, iv fluids, iv antibiotics | 30 days | |
Secondary | Functional level | Measured by proxy assessment of functional level:
Change in amount of home care during 30 days follow-up number of change of dwelling |
30 days | |
Secondary | Re-referrals to the Acute Community Health Care Service | Number of re-referrals to the ACHCS | 30 days | |
Secondary | Contact to the PCP = 30-days | Number of contact to the PCP during 30 days follow-up | 30 days |
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