Development of Clinical Indicators From the Swiss RAI-HC (IndiRAI)

Development of Frailty and Complexity Indices From Data Collected With Resident Assessment Instrument - Home Care Adapted for Switzerland

The project aims at deriving frailty (FI) and complexity (CI) indices from data collected with the Resident Instrument Assessment - Home Care adapted for Switzerland (RAI-HC). Data were collected in 2015 by trained nurses in clinical routine with the primary purposes of health state assessment and individual home care planning. The study consists in a retrospective secondary analysis of health data from the Minimal Data Set (MDS), used to derive frailty and complexity indices according to published definitions and guidelines for index derivation. The analysis further aims at estimating the predictive power of these indices on undesirable health outcomes (falls, hospitalizations and deaths). The goal is to provide home care institutions and nurses valid algorithms to compute useful clinical indicators without additional assessment that the one routinely done with the RAI-HC.

Study Overview

• Status: Completed
• Conditions: Frail Elderly Syndrome
• Intervention / Treatment: Other: Swiss RAI-HC assessment

• Study Type: Observational
• Enrollment (Actual): 10000

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 14 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

Adult applicants for home care services provided by imad (Geneva, Switzerland) who received a first RAI-HC assessment in 2015 for routine care planning purposes

Description

Inclusion Criteria:

• Men and women aged 18 or older who were assessed in 2015 with the Swiss RAI-HC in clinical routine for care planning by the Geneva Institution for Home care and Assistance (imad) in Geneva, Switzerland

Exclusion Criteria:

• Men and women aged 17 or younger and/or who did not receive a full RAI-HC assessment in 2015

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Retrospective

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Frailty Index	Index with a value ranging from 0 to 100, computed as the sum of health deficits recorded with the RAI-HC MDS divided by the number of deficits considered	1 year
Complexity Index	Index with a value ranging from 0 to 100, computed as the sum of complexity items recorded with the RAI-HC MDS divided by the number of items considered	1 year

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Falls	Falls recorded by means of follow-up RAI-HC assessments	6 months on average
Hospitalizations	Hospitalizations recorded by means of follow-up RAI-HC assessments	6 months on average
Mortality	Deceased (yes/no); collected through administrative records	through study completion, an average of 5 year

Collaborators and Investigators

• Sponsor: School of Health Sciences Geneva
• Collaborators: Institution genevoise de maintien à domicile
• Investigators: Principal Investigator: Catherine Ludwig, PhD, School of Health Sciences Geneva

Publications and helpful links

General Publications

• Hubbard RE, Peel NM, Samanta M, Gray LC, Fries BE, Mitnitski A, Rockwood K. Derivation of a frailty index from the interRAI acute care instrument. BMC Geriatr. 2015 Mar 18;15:27. doi: 10.1186/s12877-015-0026-z.
• Loeb DF, Binswanger IA, Candrian C, Bayliss EA. Primary care physician insights into a typology of the complex patient in primary care. Ann Fam Med. 2015 Sep;13(5):451-5. doi: 10.1370/afm.1840.
• Morris JN, Fries BE, Steel K, Ikegami N, Bernabei R, Carpenter GI, Gilgen R, Hirdes JP, Topinkova E. Comprehensive clinical assessment in community setting: applicability of the MDS-HC. J Am Geriatr Soc. 1997 Aug;45(8):1017-24. doi: 10.1111/j.1532-5415.1997.tb02975.x.
• Armstrong JJ, Stolee P, Hirdes JP, Poss JW. Examining three frailty conceptualizations in their ability to predict negative outcomes for home-care clients. Age Ageing. 2010 Nov;39(6):755-8. doi: 10.1093/ageing/afq121. Epub 2010 Sep 21. No abstract available.
• Ludwig C, Busnel C. Derivation of a frailty index from the resident assessment instrument - home care adapted for Switzerland: a study based on retrospective data analysis. BMC Geriatr. 2017 Sep 7;17(1):205. doi: 10.1186/s12877-017-0604-3.

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2015
• Primary Completion (Actual): December 31, 2015
• Study Completion (Actual): April 11, 2023

Study Registration Dates

• First Submitted: April 24, 2017
• First Submitted That Met QC Criteria: May 2, 2017
• First Posted (Actual): May 3, 2017

Study Record Updates

• Last Update Posted (Actual): April 12, 2023
• Last Update Submitted That Met QC Criteria: April 11, 2023
• Last Verified: October 1, 2022

More Information

Terms related to this study

• Keywords: Aging; Nursing; Frailty; Home Care Services; Complexity
• Other Study ID Numbers: 74217

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: The coded datasets supporting the findings of this study are not publicly available for they belong to imad and are not the property of the authors of the study. The data analyzed for the study could be made available from the authors upon reasonable request and with prior agreement by imad.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No