- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02167737
The Emergency Department Stopping Elderly Accidents, Deaths and Injuries Program (ED-STEADI)
"ED-STEADI:" The Emergency Department Stopping Elderly Accidents, Deaths and Injuries Program (A Pilot Study)
Study Overview
Status
Intervention / Treatment
Detailed Description
This prospective, randomized controlled study will be conducted when there is a member of the research team available to consent patients at a Level I Trauma Center with approximately 90,000 annual ED visits across all age groups. Each potentially eligible patient will be identified by the research team and approached in the ED. Consented and enrolled patients will be assigned a study identification number and the enrollment documented by a member of the research team in the ED's electronic medical record after subjects are confirmed to meet inclusion and exclusion criteria. Subjects will be assigned randomly (by using a computer generated sequence) to either the control or intervention study arms.
Subjects in the control arm will have demographic data collected, a baseline Falls Efficacy Scale (FES) and Vulnerable Elders Survey (VES) screening completed and two STEADI Tool Kit mobility tests administered (the "TUG" [Timed Up and GO] and the 30-Second Chair Stand test). The FES and VES are validated surveys measuring fall concern and functional decline. The research team will advise them that they have a risk of falling as identified by inclusion criteria and that we are advising them to take action to prevent future falls. They will be given the brochure, "What YOU Can Do to Prevent Falls," that is standardized information recommended in the STEADI Tool Kit for Health Care Providers by the Centers for Disease Control (CDC).
Subjects in the active arm will also have demographic data collected, a baseline FES and VES screening completed, and two STEADI Tool Kit mobility tests administered (the "TUG" [Timed Up and GO] and the 30-Second Chair Stand test). Their risk of falling will be reviewed with them using a bedside decision aid indicating what they can do to decrease their risk. Particular attention will be given to personalizing their fall risk. The fall prevention management options will be presented in a value neutral fashion, along with the advantages and disadvantages of each option. They will have an opportunity to discuss what outcomes are the most important to them and choose the management options from the list provided that are the most valuable to them. Study and treatment team members will then work with this agreed upon selection to provide reliable intervention and outpatient follow up to improve the gains that can be realized in an integrated healthcare system. If the participant chooses to do their own home safety evaluation, they will be provided with a checklist to guide them in looking for hazards in their home and how to fix them. The patient will keep the original copy of their decision aid with their agreed-upon selected treatment options, and a copy of it will be placed in the subject's study file. All actions that are in response to the subject's selected plan (prescriptions, appointments, etc.) will also be documented in the study file.
Both groups will have phone follow-up at 6 weeks post ED visit, and then again at 3, 6, 9 and 12 months to collect self-reported data about goal completion and fall history. The last phone follow-up will include an exit FES and VES reassessment. All participants in both arms will have data collected about their inpatient and outpatient visits throughout the network during the study period to corroborate their self-report (e.g., occupational therapy, physical therapy visits, hospital admissions or ER visits for injuries related to a fall, etc.).
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Pennsylvania
-
Bethlehem, Pennsylvania, United States, 18017
- Lehigh Valley Hospital, Emergency Medicine Research
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
Patients must:
- Be 65 years of age or older
- Be discharged home from the ED
- Be able to speak English.
- Be competent and able to give consent (not in critical condition, intoxicated or otherwise incapacitated)
- Have a mechanical fall risk as defined by one of the following:
Reports to have fallen in the last year Reports worrying about falling Admits they feel unsteady when standing or walking
Exclusion Criteria:
Patients must not:
- Be younger than 65 years old
- Be discharged from the ED to anywhere, but home (i.e., must not be discharged to family member's home, personal care facility, nursing home, group home, etc.)
- Be unable to speak English
- Be incompetent and unable to give consent (in critical condition, intoxicated or otherwise incapacitated)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Bedside Decision Aid Group
This arm will include study participants who are randomized to the group utilizing the bedside decision aid, which has hospital staff arrange fall-risk reduction interventions (e.g., home safety checks, exercise programs, vision checks, etc.).
|
This group will have an initial FES and VES screening completed in the ED, the TUG test and Chair 30-Second Stand test, and the participant's risk of falling evaluated using our Bedside Decision worksheets. A study team member explains what subjects can do to decrease their risk of falling and discuss what mobility goals are the most important to them. Participants will receive a follow-up telephone call approximately six weeks after their discharge from the ED to collect self-reported data about goal completion, and then at four additional times--three, six, nine and 12 months--over the course of a year to collect self-reported data such as fall history. |
Active Comparator: Control Arm
Participants in the control/comparator arm will experience the same study procedures with the exception of not using the Bedside Decision Aid and instead being given the Centers for Disease Control (CDC) brochure, "What You Can Do to Prevent Falls," and arranging for their own fall prevention strategies.
|
This group will also have an initial FES and VES screening completed in the ED and the same two mobility tests (TUG and Chair 30-Second Stand). Study staff will advise subjects on how to take action to prevent falls and give them a brochure, "What YOU Can Do to Prevent Falls," from the CDC's "STEADI Tool Kit for Health Care Providers." Participants will receive a telephone call approximately six weeks after their discharge from the ED to collect self-reported data about goal completion, and then at four additional times--three, six, nine and 12 months--over the course of a year to collect self-reported data such as fall history. |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Efficacy of the bedside decision tool/worksheet
Time Frame: 12 months
|
A single sheet bedside decision aid form/worksheet will be used to engage the patient in a discussion about fall prevention, the aim of which is to increase patient interest and participation in different management options that decrease fall risk.
Patients will be followed up via phone calls re: their management option choices and how thorough/successful they were in completing them.
|
12 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Gender differences in use of the decision tool
Time Frame: 12 months
|
Responses from the bedside decision tool choices will be grouped by gender to determine if men and women select different management options and/or have different patterns in completing them.
|
12 months
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Gender differences in fall management choices
Time Frame: 12 months
|
Participants in *both* study arms will have phone follow-ups at the same time intervals to determine if men and women have different management option preferences and/or different patterns in completing them.
|
12 months
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Marna R. Greenberg, DO, MPH, LeHigh Valley Hospital
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- #PRO-00001450
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Accidental Falls
-
The Hospital District of SatakuntaCompleted
-
University Hospital, Basel, SwitzerlandCompletedAccidental Falls | Underlying Disease of FallsSwitzerland, Germany
-
Shirley HuangJintronixRecruiting
-
Sigma Theta Tau InternationalRecruiting
-
University of Maryland, BaltimoreVA Maryland Health Care SystemRecruitingAccidental FallsUnited States
-
Universidad Miguel Hernandez de ElcheSocio- Health Center Puente Real ( Health Care for Older © ) of BadajozCompleted
-
The Hong Kong Polytechnic UniversityCompletedAccidental FallsHong Kong
-
Montana State UniversityCompletedAccidental FallsUnited States
-
University of PittsburghBoston University; Foundation for Physical Therapy, Inc.; Mt. Ascutney Hospital...CompletedAccidental FallsUnited States
-
Duke UniversityNational Institute of Nursing Research (NINR); The Carolinas Center for Medical...CompletedAccidental FallsUnited States
Clinical Trials on Bedside Decision Aid
-
University of LeedsBaxter Healthcare Corporation; National Health Service, United Kingdom; Foundation... and other collaboratorsCompletedChronic Kidney FailureUnited Kingdom
-
Massachusetts General HospitalCompletedCoronary Artery Disease | Stable AnginaUnited States
-
University Hospital HeidelbergInnovationsfonds des Gemeinsamen Bundesausschusses, GermanyCompletedPatient Decision Aid | Treatment As UsualGermany
-
Massachusetts General HospitalUnknownDecision Making | Video Decision AidsUnited States
-
Kaiser PermanenteFoundation for Informed Medical Decision MakingCompletedObesity | Obesity, Morbid | Bariatric Surgery | Decision AidsUnited States
-
Case Comprehensive Cancer CenterCompletedProstate CancerUnited States
-
Duke UniversityFoundation for Informed Medical Decision MakingCompletedOsteoarthritisUnited States
-
University of UtahPatient-Centered Outcomes Research Institute; Mayo Clinic; Northwestern University and other collaboratorsActive, not recruitingAtrial FibrillationUnited States
-
University of MichiganNational Cancer Institute (NCI)Completed
-
Massachusetts General HospitalCompleted