Status:

ACTIVE_NOT_RECRUITING

The Impact of Domiciliary Versus 'Hub' Based Comprehensive Geriatric Assessment on Clinical and Process Outcomes Among Older Adults Attending Community Specialist Teams: a Randomised Controlled Trial.

Lead Sponsor:

University of Limerick

Conditions:

Frailty

Comprehensive Geriatric Assessment

Eligibility:

All Genders

75+ years

Phase:

NA

Brief Summary

The investigators plan to implement a randomised controlled trial to examine the impact of domiciliary (home based) versus 'hub-based' Comprehensive Geriatric Assessment (CGA) on clinical and process ...

Detailed Description

CGA is defined as a "multidimensional interdisciplinary diagnostic process focused on determining a frail elderly person's medical, psychological and functional capability in order to develop a coordi...

Eligibility Criteria

Inclusion

  • Referred to the CST hub from a General Practitioner (urgent referral) or from the ED at University Hospital Limerick.
  • All of criteria 1-5 must be met
  • 75 years and over
  • Evidence of frailty, scoring between 4 and 6 on the Rockwood Clinical Frailty Scale (pre-frail, mildly frail or moderately frail)
  • Resides within CHO 3 and the catchment area of the relevant ICPOP hub
  • Patient has been assessed in-person by the referrer
  • Patient has not had MDT input within the last three months (excluding OPTIMEND team)
  • And any one of criteria 6-10 must be met:
  • Fall within the last month unrelated to acute cardiac or neurological cause \& no previous falls assessment
  • Increased dependency or increased carer burden in the last month
  • A deterioration in swallow in the last month including symptoms of recurrent chest infections, weight loss, coughing when eating/drinking, self-modifying diet secondary to difficulties
  • Adverse drug reaction within the last month excluding allergic reaction Referred from ED/AMU following review by consultant in Emergency Medicine, Acute Medicine, Geriatric Medicine, General Medicine or Frailty at the Front Door team

Exclusion

  • Present with an acute neurological or cardiovascular event
  • Are more appropriate to an alternative care pathway or service e.g. primary care or geriatric medicine clinic
  • Present with injuries, unless the injury has already been appropriately managed,
  • Are experiencing an acute medical illness requiring treatment in an acute hospital setting
  • If care is being provided by other health care professionals at the time of referral and it is apparent that they are working to meet goals aligned with the current service
  • They require investigation or treatment not available in the relevant ICPOP hub (unless these investigations are already being arranged elsewhere)
  • They have had MDT input in the last three months
  • Have confirmed or suspected Covid-19 infection
  • Or other exclusions at the discretion of the integrated care team based on clinical expertise and available resource.

Key Trial Info

Start Date :

January 15 2024

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

July 31 2026

Estimated Enrollment :

106 Patients enrolled

Trial Details

Trial ID

NCT06205238

Start Date

January 15 2024

End Date

July 31 2026

Last Update

August 20 2025

Active Locations (1)

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1

Community Specialist Team Hub

Limerick, Munster, Ireland