- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03456128
Reducing Disability Following Hospital Discharge in Vulnerable Older Adults: The CAPABLE Intervention (CAPABLE-VNSNY)
Study Overview
Detailed Description
Currently, there is no evidence-based approach to improve post-hospitalization functional decline. CAPABLE uses a novel inter-professional team involving an occupational therapist, nurse, and handyman to improve ADLs in older adults post-hospitalization.
In a Center for Medicare & Medicaid Innovation (CMMI) demonstration project, CAPABLE demonstrated a 45% reduction of ADL difficulties in older adults from baseline to five months.The significance of this improvement could make the difference between aging at home independently and relocating to institutional care. While these results are encouraging, CAPABLE needs evaluation in real world health delivery contexts with more ethnic diversity.The purpose of this study is to test the effectiveness of CAPABLE in older adults in an active community health care program.
Interventions: CAPABLE Intervention: Participants in the treatment group will receive up to 10 in-home sessions (≤6 visits with an occupational therapist and ≤4 visits from a nurse)-and up to $1500 in safety and modification services from a licensed handyman. Each treatment participant will receive each intervention component (education, assessment, and identification of functional goals, specific strategies tailored to goals and based on protocols). Usual Care Group: Participants in the usual care group will not receive visit from study clinicians and will continue to receive their usual VNSNY CHOICE benefits and healthcare. After baseline, all study participants will be reassessed at 20 weeks and possibly a third interview at 52 weeks. Assessments will be completed by a research assistant masked to treatment condition.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Melissa Trachtenberg, BA
- Phone Number: 212-760-3112
- Email: Melissa.Trachtenberg@vnsny.org
Study Contact Backup
- Name: Sarah L. Szanton, PhD, RN
- Phone Number: (410) 502-2605
- Email: sszanto1@jhu.edu
Study Locations
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New York
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New York, New York, United States, 10001
- Recruiting
- Visiting Nurse Service of New York
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Contact:
- Kathryn H Bowles, PhD
- Phone Number: 212-609-5640
- Email: mailto:Kathryn.Bowles@vnsny.org
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Aged ≥ 65 years old;
- Are 60 days post-hospitalization in an acute care setting and have had a Visiting Nurse Service of New York (VNSNY) visit;
- Have difficulty with at least one activity of daily living (ADL);
- Are a member of the VNSNY CHOICE Medicare Advantage Health Plan;
- Are able to stand with or without assistance; and
- Are available during the intervention period
Exclusion Criteria:
- Have significant cognitive impairment identified by the Callahan screening tool;
- Do not speak English or Spanish;
- Have had more than 3 hospitalizations within the past 12 months;
- Are actively receiving radiation or chemotherapy;
- Have plans to relocate in less than one year;
- Have diagnoses of the following: Dementia, Alzheimer's, Other Cerebral Degeneration, and serious cognitive impairment or OASIS assessment level 3 response on M1034 "serious progressive conditions that could lead to death within a year"
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Randomized
- Interventional Model: Single Group Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Intervention
The experimental group will receive CAPABLE services.
These include ≤10 sessions: ≤ 6 with an Occupational Therapist (OT) and ≤ 4 sessions with a Registered Nurse (RN) and up to ≤ $1,500 of home safety and home modifications from a licensed handyman who is guided by the OT.
The OT and RN sessions will target participants' self-identified functional goals (e.g., getting safely into the tub, getting upstairs to sleep in own bed).
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It involves up to 10 in-home tailored interventions of approximately 60 minutes duration each over a 5-month period.
The assessment driven interventions are delivered by an Occupational Therapist (OT) (≤ 6 home visits for ≤ 1hour), a Registered Nurse (RN) (≤ 4 home visits for ≤ 1hour), and a handyman (HM) team.
|
No Intervention: Usual Care
Participants in the usual care group will not receive visit from study clinicians and will continue to receive their usual VNSNY CHOICE benefits and healthcare.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Mean ADL Difficulty Score
Time Frame: 20-week follow-up period
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Change in ADL- the range is 0 - 16, with higher scores indicating that the participant needs a lot of help with performing many ADLs (is more disabled) and lower scores indicating that the participant is not disabled
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20-week follow-up period
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Sarah L. Szanton, PhD, RN, Johns Hopkins University
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- IRB00141968
- 1R01AG056607-01 (U.S. NIH Grant/Contract)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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.
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