Clinical Trial Details
— Status: Completed
Administrative data
| NCT number |
NCT05915156 |
| Other study ID # |
CIUSSS-SMHC-20-21 |
| Secondary ID |
|
| Status |
Completed |
| Phase |
N/A
|
| First received |
|
| Last updated |
|
| Start date |
April 1, 2021 |
| Est. completion date |
December 31, 2021 |
Study information
| Verified date |
June 2023 |
| Source |
Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal |
| Contact |
n/a |
| Is FDA regulated |
No |
| Health authority |
|
| Study type |
Interventional
|
Clinical Trial Summary
An early discharge of frail elderly individuals from post-acute care services may lead to a
decline in their ability to perform daily activities and cause social, emotional, and
psychological distress. Montreal West Island Integrated University Health and Social Services
Center in Quebec implemented a pilot program called Post-Acute Home Physiotherapy (PAHP) to
address this concern. This program aimed to provide a timely and intense out-patient
physiotherapy service to ensure maintenance and optimization of the physical capacities
acquired in post-acute care and also to contribute acceleration of the turnover of
rehabilitation beds. The objective of this study was to assess the impact of the PAHP program
on the functional independence, physical and mental health of elderly individuals, as well as
their safety. Additionally, it aimed to identify the healthcare needs, both physical and
psychological, of elderly individuals after their discharge from post-acute care services.
Description:
Seniors play a key role in our society by participating in social activities, volunteering,
and for some, working past the age of 80. By 2030, one out of 4 Canadians will be over the
age of 65 and life expectancy will raise to 86.2 years for women and 82.9 for men. The global
share of older people will continue to grow as a proportion of the world population, reaching
21.1% by 2050. While people are living longer almost everywhere, including in Canada, the
prevalence of disabilities and multimorbidity is increasing as the population ages.
Multimorbidity, which is defined as the coexistence of two or more chronic conditions,
becomes the norm. In Canada, the overall prevalence of multimorbidity for people aged 40
years and over was 26.5% in 2011/12 and this prevalence increases substantially to 66.3 % for
people aged ≥ 85 years. This brings a tremendous challenge to the Canadian healthcare system
where high healthcare users, representing only 0.5% of the population aged 50 to 74 and 2.6%
of those aged 75 or older, but accounting for about half of all hospital days (45.6% and
56.1%, respectively) recorded for people of these ages.
Hospitalization and prolonged stays in acute care can lead to a functional decline which is
one of the most common negative outcomes of hospitalization. Post-hospitalization functional
decline has been shown to be sustained up to one year following discharge, and non-recovery
to baseline functional status has been associated with increased risk of re-hospitalization,
prolonged disability, and death (up to three years). This loss of functional capacity in the
elderly raises the need for more innovative and specialized care to help restore and promote
seniors' independency after stays in acute care settings. Post-acute care is a set of
services and an approach to manage and restore human activity. Post-acute care includes all
services needed by end-users requiring rehabilitation to regain functional autonomy. Instead
of being discharged from acute care back home or directly to nursing homes, many seniors
first transition to post-acute care to receive specialized inpatient and/or outpatient
rehabilitation.
In order to provide a timely and intense out-patient physiotherapy service to ensure
maintenance and optimization of the physical capacities acquired in post-acute care and also
to contribute acceleration of the turnover of rehabilitation beds, the MWI IUHSSC then
created a pilot program in November 2017, the Post-acute home physiotherapy program or PAHP.
The PAHP program was built in accordance to INESSS recommendation to address the
rehabilitation needs of clients ready to return home after transiting in a post-acute
facility, but still requiring rehabilitation to maximize their autonomy.
The PAHP program was implemented across the 4 local care centres of the MWIIUHSSC's territory
between May 2018-May 2019 serving 163 clients. PAHP was designed for all elderlies in need
for additional rehabilitation to be seen by a physical therapist technologist within 48hrs of
being discharged from post-acute care and receive physical therapy 3 days/week for a period
of 6 weeks. However, the impact of the PAHP program and whether it addresses the healthcare
needs of the older people is unknown.
The main objective of this study is to assess the effects of the pilot PAHP program on
various aspects of an individual's well-being. These aspects include functional independence,
physical and mental health, and overall safety. Additionally, the study aims to identify the
physical, mental, and psychological needs of elderly individuals after they have been
discharged from post-acute services.
