Clinical Trial: Dutch EASYcare Study

Study Status: Completed
Recruit Status: Completed
Study Type: Interventional

Official Title: Effectiveness of EASYcare-Based Geriatric Intermediate Care

Brief Summary: The purpose of this study is to study the effects of nursing home visits in independently living elderly people on their functional performance and health-related quality of life. The general practitioner (GP) can refer elderly people to this intervention model after identification of a problem in cognition, mood, behavior, mobility, or nutrition. A specialist geriatric nurse visits the patients at home up to six times and coaches the patient in cooperation with the GP and geriatrician.

Detailed Summary:

General practitioners (GPs) in the Western world have to anticipate the increasing age and health care demands of their patients. A considerable proportion of those older patients have reduced functional status and quality of life, which may affect their feelings of autonomy and ability to live independently. Even with considerable disability, most patients prefer to stay at home. Because of their complex clinical presentations and needs, these patients require a special approach to their evaluation and care.

Intermediate care is a possible answer to these changing demands, although the efficacy of these programs is a subject of vivid debate.

With the Dutch Geriatric Intermediate Care Programme (DGIP) we developed an Intermediate Care model to study efficacy aspects of problem based intermediate care. DGIP is an intermediate care program in which the GP refers elderly patients with a problem in cognition, mood, behavior, mobility, and nutrition. A geriatric specialist nurse applies a guideline based intervention in a maximum of six visits during a maximum of three months. The nurse starts the intervention with the application of the EASYcare instrument for geriatric screening. The EASYcare instrument assesses (instrumental) activities of daily life, cognition, mood, and includes a goal setting item. During the intervention the nurse regularly consults the referring GP and a geriatrician.

Objectives

  • To determine the effects of the Dutch EASYcare Study Geriatric Intermediate care Programme compared to regular medical care in improving health related quality of life in independently living elderly persons and their informal caregivers who contact the GP with one of a variety of geriatric problems
    Sponsor: Radboud University

    Current Primary Outcome:

    • Functional performance (independent) activities of daily living measured using Groningen Activity Restriction Scale [ Time Frame: 3 months ]
    • Mental health using subscale mental health MOS-20 [ Time Frame: 3 months ]
    • Informal caregiver burden using Zarit Burden Interview [ Time Frame: 3 months ]


    Original Primary Outcome:

    • Functional performance (independent) activities of daily living measured using Groningen Activity Restriction Scale
    • Mental health using subscale mental health MOS-20
    • Informal caregiver burden using Zarit Burden Interview


    Current Secondary Outcome:

    • Type of residence (independent, home for the elderly, nursing home) [ Time Frame: 3 months ]
    • Cost effectiveness [ Time Frame: 6 months ]
    • Mobility using Timed Up and Go test [ Time Frame: 3 months ]
    • Overall health related Quality of life using MOS-20 [ Time Frame: 3 months ]
    • Well-being using Cantril Self-anchoring ladder and Dementia Quality of Life [ Time Frame: 3 months ]
    • Cognition using Mini Mental State Examination [ Time Frame: 6 months ]
    • Social functioning using Loneliness scale de Jong-Gierveld [ Time Frame: 3 months ]
    • Subjective treatment effects using Patient Enablement Instrument [ Time Frame: 3 months ]
    • Mortality [ Time Frame: within a period of maximum two years ]
    • Time spent on care by informal caregiver [ Time Frame: 3 months ]


    Original Secondary Outcome:

    • Type of residence (independent, home for the elderly, nursing home)
    • Cost effectiveness
    • Mobility using Timed Up and Go test
    • Overall health related Quality of life using MOS-20
    • Well-being using Cantril Self-anchoring ladder and Dementia Quality of Life
    • Cognition using Mini Mental State Examination
    • Social functioning using Loneliness scale de Jong-Gierveld
    • Subjective treatment effects using Patient Enablement Instrument
    • Mortality
    • Time spent on care by informal caregiver


    Information By: Radboud University

    Dates:
    Date Received: March 11, 2005
    Date Started: April 2003
    Date Completion:
    Last Updated: August 9, 2007
    Last Verified: August 2007