Actively Recruiting
AdvantAGE: Implementation and Evaluation of an Interprofessional Tranistional Care Model for Frail Older Adults
Led by Thekla Brunkert · Updated on 2024-02-02
250
Participants Needed
1
Research Sites
129 weeks
Total Duration
On this page
Sponsors
T
Thekla Brunkert
Lead Sponsor
H
Health Department of the Canton of Basel-Stadt
Collaborating Sponsor
AI-Summary
What this Trial Is About
This clinical trial at the University Department of Geriatric Medicine FELIX Platter in Basel, Switzerland, is designed to evaluate a new transitional care model aimed at helping frail older adults after they get discharged from the hospital. The AdvantAGE study aims to explore the following questions: * Does the new care model help reduce the number of patients who need to return to the hospital within 90 days? * How effective is the implementation of this care model? Participants in the trial will be followed by advanced practice nurses for up to 90 days after hospital discharge. The patients and their caregivers will receive support in coordinating care, managing medications, and learning to manage the patient's health conditions on their own. Additionally, they will have the opportunity to engage in discussions about advanced care planning.
CONDITIONS
Official Title
AdvantAGE: Implementation and Evaluation of an Interprofessional Tranistional Care Model for Frail Older Adults
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Currently admitted to the acute or rehabilitation ward of University Department of Geriatric Medicine
- Reside in Basel-Stadt
- Able to speak and understand German
- Scheduled to be discharged to their home
- 65 years or older
- Identified by a clinician as having a high risk of deterioration due to frailty
- Diagnosed with a complex chronic disease requiring support in self-management and disease management, or
- Facing socially challenging situations such as living alone without a supportive network or lacking a general practitioner, or
- Admitted for an acute illness with a brief hospital stay and need support in self- and disease management, continuity of therapy plan, and close monitoring
You will not qualify if you...
- Residing in a nursing home or newly admitted to one
- Lacking informal caregivers and having severe cognitive impairment (MMS �34 23)
- Scoring less than 50 on the motoric domain of the Functional Independence Measure (FIM)
- Having a psychiatric disorder that significantly affects the ability to manage daily life at discharge
AI-Screening
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Trial Site Locations
Total: 1 location
1
Universitäre Altersmedizin FELIX PLATTER
Basel, Switzerland, 4055
Actively Recruiting
Research Team
M
Mario Ernst
CONTACT
I
Isabel Pfundstein
CONTACT
How is the study designed?
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
NA
Model
SINGLE_GROUP
Primary Purpose
HEALTH_SERVICES_RESEARCH
Number of Arms
1
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