Follow Home Visits After Discharge

Status Completed

Clinical Trial Summary

The study aims to assess whether a follow home visit after discharge of frail elderly patients from Nykøbing Falster Hospital reduces the risk of readmission within 180 days.

Staff from the hospital ward identifies patients fulfilling the inclusion criteria and refers the patients to two project nurses at the hospital (follow home team). One of the project nurses gets the informed consent from the patient, or in case of a patient who is not able to give informed consent, from the family and general practitioner. The patient is then randomized to intervention (follow home visit after discharge) or control.

In the intervention group, the hospital project nurse and the patient meets with the municipal nurse in the patient's home on the same day the patient is being discharged from the hospital. During this visit the discharge from the hospital and the actual functioning of the patient in his own surroundings is reviewed, using a structured assessment.

Clinical Trial Description

The study consists of two parts: First, the project nurse reviews the patients hospitalization and discharge together with the nurse from the ward. Next, the patient is discharged from the hospital and is driven by the project nurse from the hospital to the patient's home where they meet the nurse from the municipality. Together with the patient the two nurses review:

- Cognitive skills

- Medicine

- Nutrition

- Mobility

- Level of functioning

- Future appointments in the health care sector

All patients in the project - both patients in the intervention group and patients in the control group - will receive treatment and care equivalent to normal applicable quality standards with discharge from the hospital.

It is expected that the study will demonstrate a reduction of hospital readmissions within 180 days in the intervention group with 14 % (with a power of 90% and a significance level of 5%). There will be a need for 200 patients in both the control and intervention group, ie 400 patients in total. ;

Study Design

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention

Related Conditions & MeSH terms

Clinical Trial Details

NCT number	NCT02318680
Study type	Interventional
Source	Roskilde County Hospital
Contact
Status	Completed
Phase	N/A
Start date	January 2013
Completion date	January 2015

View Details

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Clinical trials are conducted in a series of steps, called phases - each phase is designed to answer a separate research question.

Phase 1: Researchers test a new drug or treatment in a small group of people for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.
Phase 2: The drug or treatment is given to a larger group of people to see if it is effective and to further evaluate its safety.
Phase 3: The drug or treatment is given to large groups of people to confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information that will allow the drug or treatment to be used safely.
Phase 4: Studies are done after the drug or treatment has been marketed to gather information on the drug's effect in various populations and any side effects associated with long-term use.