Case Managers to Frail Older People a Randomized Controlled Trial

The aim of is to test the effects of a model for care (case management) to older people with high healthcare consumption and functional dependency on healthcare consumption, quality of life, functional ability and experiences of care.

Study Overview

• Status: Completed
• Conditions: Frail Elderly
• Intervention / Treatment: Other: Case management

• Study Type: Interventional
• Enrollment (Actual): 153
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Sweden
  • Lund, Sweden, SE-22100
    • Lund University, Faculty of Medicine, Department of Health Sciences

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 65 years and older (Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• aged 65 or over
• need help with at least two activities of daily living
• been admitted to hospital on at least two occasions, or
• have had at least four contacts with outpatient or primary care during the previous twelve months,
• be able to communicate verbally
• have no cognitive impairment

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Case Management

Other: Case management; Nurses and a physiotherapist (PT) worked as case managers (CM). The intervention lasted 12 months and comprised 4 dimensions. The first was traditional CM tasks: assessment, planning, monitoring, care coordination and evaluation. Home visits were made at least once a month. The second and third was general and specific information related to the participants' situation. The fourth part included aspects of continuity and safety. The PT also paid home visits and made an assessment regarding physical function and balance. The intervention consisted of multidimensional prevention of falls and/or consequences of falls, and supporting and motivating the participant to increased physical activity. When those in the control group had participated for 12 months they were offered the intervention.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Health care consumption	two years (one year before vs after baseline)
Health care costs	two years (one year before vs after baseline)
Feelings of loneliness	baseline and then after 3,6,9,12,24 months
Depressive symptoms	baseline and then after 3,6,9,12,24 months
Health Related Quality of Life	baseline and then after 3,6,9,12,24 months
Number of falls	baseline and then after 3,6,9,12,24 months

Secondary Outcome Measures

Outcome Measure	Time Frame
Life Satisfaction	baseline and then after 6,12,24 months
Health complaints	baseline and then after 3,6,9,12,24 months
Knowledge about prescribed drugs	baseline and then after 3,6,9,12,24 months
Attitudes towards prescribed drugs	baseline and then after 3,6,9,12,24 months
Drug use	baseline and then after 3,6,9,12,24 months
Activities and social participation	baseline and then after 3,6,9,12,24 months
Functional capacity	baseline and then after 3,6,9,12,24 months
Balance	baseline and then after 3,6,9,12,24 months
Timed up and go (TUG)	baseline and then after 3,6,9,12,24 months
Risk of falling	baseline and then after 3,6,9,12,24 months
Fear of Falling	baseline and then after 3,6,9,12,24 months

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Experiences of care	qualitative interviews with participants, next of kins and case managers	approximately one year

Collaborators and Investigators

• Sponsor: Lund University
• Investigators: Principal Investigator: Ingalill Rahm Hallberg, PhD, Lund University

Publications and helpful links

General Publications

• Kristensson J, Ekwall AK, Jakobsson U, Midlov P, Hallberg IR. Case managers for frail older people: a randomised controlled pilot study. Scand J Caring Sci. 2010 Dec;24(4):755-63. doi: 10.1111/j.1471-6712.2010.00773.x.

Study record dates

Study Major Dates

• Study Start: October 1, 2006
• Primary Completion (Actual): April 1, 2011
• Study Completion (Actual): April 1, 2012

Study Registration Dates

• First Submitted: April 9, 2013
• First Submitted That Met QC Criteria: April 9, 2013
• First Posted (Estimate): April 11, 2013

Study Record Updates

• Last Update Posted (Estimate): April 11, 2013
• Last Update Submitted That Met QC Criteria: April 9, 2013
• Last Verified: April 1, 2013

More Information

Terms related to this study

• Keywords: Health Status; Case Management; Accidental Falls; Delivery of Health Care; Frail Elderly; Health Care Economics; Health Services Administration
• Other Study ID Numbers: 499/2008