Interprofessional Health Needs Assessment (IHNA) for Older Adults Living at Home (Impact-INHA)
Implementing and Evaluating the Impact of Interprofessional Health Needs Assessment (INHA) for Older Adults Living at Home
The aim of this randomized controlled trial is to evaluate the effectiveness and cost-effectiveness of the Interprofessional Health Needs Assessment (IHNA) in older adults living at home. Specifically, the trial will assess the effects of IHNA on health-related quality of life, social care-related quality of life, survival, and health service utilization.
The primary objective is to determine the effect of IHNA on participants' health-related quality of life at 12 months. Secondary objectives are to assess its effects on social care-related quality of life, survival (time to death), health service utilization, and quality-adjusted life years (QALYs) at 6 and 12 months.
Přehled studie
Postavení
Intervence / Léčba
Detailní popis
Early identification of health needs among home-dwelling elderly adults is crucial for maintaining health and function, improving quality of life, and preventing hospitalizations. When allocating municipal health and care services, healthcare professionals assess functional abilities and health needs. Based on this assessment, services such as emergency alarms, everyday rehabilitation, home nursing care, practical assistance at home, and assistive devices are assigned. However, there is no standardized approach to what should be included in these assessments or how they should be conducted.
This project develops a procedure for interprofessional health needs assessment (IHNA) to systematically identify and address the health needs of older adults living at home. IHNA integrates the older adult's values and preferences into the assessment, ensuring that interventions and services align with their priorities. IHNA incorporates screening tools for a structured and holistic assessment of health and social domains.
The project involves co-creation of IHNA with healthcare professionals and older adults, workplace training in the effective use of IHNA, and implementation in two Norwegian municipalities through a randomized controlled trial.
By developing interprofessional practices for assessing health needs and equipping healthcare professionals with screening tools and training, the project will help municipalities provide fairer, more effective services to home-dwelling older adults.
Typ studie
Zápis (Odhadovaný)
Fáze
- Nelze použít
Kontakty a umístění
Studijní kontakt
- Jméno: Arnt Egil Ydstebø
Studijní místa
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Sandnes, Norsko, 4306
- Nábor
- Sandnes Municipality
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Kontakt:
- Martine Kajander, PhD
- Telefonní číslo: +4747859070
- E-mail: martine.marie.kajander@sandnes.kommune.no
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Stavanger, Norsko, 4014
- Nábor
- Stavanger Muncipality
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Kontakt:
- Arnt Egil Ydstebø, PhD
- Telefonní číslo: +47 996 25 223
- E-mail: arnt.egil.ydstebo@stavanger.kommune.no
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Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
- Starší dospělý
Přijímá zdravé dobrovolníky
Popis
Inclusion Criteria:
- 65 years and older
- applying for a municipal health and care service at home (i.e., practical assistance, home nursing, assistive devices, rehabilitation, day care center)
- the health care service will have a duration of more than 2 weeks
Exclusion Criteria:
- younger than 65 years
- diagnosed with dementia
- life expectancy shorter than 6 months
- applying for a nursing home placement
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Výzkum zdravotnických služeb
- Přidělení: Randomizované
- Intervenční model: Paralelní přiřazení
- Maskování: Dvojnásobek
Zbraně a zásahy
Skupina účastníků / Arm |
Intervence / Léčba |
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Experimentální: INHA Intervention group
The intervention group will be assessed using INHA
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Interprofessional teams with a nurse, physiotherapist, or occupational therapist from Stavanger and Sandnes municipalities will assess participants in the intervention group using the Interprofessional Health Needs Assessment (INHA) procedure. INHA includes screening tools to assess mobility, cognition, mental health, nutrition and oral health, vision and hearing, activities of daily living, social network, physical and behavioural health. Based on the IHNA findings, the interprofessional teams, in collaboration with the older adult, will decide on allocating municipal health services, making referrals, and giving advice on available preventive and health promotion interventions from the municipality's health and care services and relevant voluntary and private actors. |
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Žádný zásah: Control group
The participants in the control group will be assessed by the standard assessment form used by the municipality and have services allocated as usual.
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Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
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Health-related quality of life
Časové okno: Baseline, 6 months and 12 months
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Health-related quality of life will be assessed using the EuroQol 5-Dimension 5-Level questionnaire (EQ-5D-5L).
The EQ-5D-5L descriptive system comprises five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression.
Each dimension has five response levels: no problems, slight problems, moderate problems, severe problems, and extreme problems/unable to perform.
Responses are combined into a 5-digit health-state profile, with 11111 representing the best health state and 55555 the worst health state.
Health state will be converted into a utility index score, with higher scores indicating better health-related quality of life.
The primary outcome will be the change in EQ-5D-5L utility index score from baseline to 12 months.
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Baseline, 6 months and 12 months
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Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Self-rated health
Časové okno: Baseline, 6 months, and 12 months
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The EuroQol Visual Analog Scale (EQ VAS) will be assessed as a secondary outcome measure of self-rated health. Participants rate their current health on a scale from 0 to 100. A score of 100 is equivalent to the best possible health. A score of 0 is equivalent to the worst possible health. Changes in EQ VAS scores from baseline to 6 months and 12 months will be evaluated, with higher scores indicating better perceived health. |
Baseline, 6 months, and 12 months
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Social care related quality of life
Časové okno: Baseline, 6 months, and 12 months
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The Adult Social Care Outcomes Toolkit (ASCOT) will be used as a secondary outcome measure of social care-related quality of life.
ASCOT covers eight domains: control over daily life, personal cleanliness and comfort, food and drink, personal safety, social participation and involvement, occupation, accommodation cleanliness and comfort, and dignity.
Each domain has four response options scored from 0 to 3, with higher scores indicating better outcomes.
Domain responses will be combined into an overall ASCOT score, with higher scores indicating better social care-related quality of life.
Changes in ASCOT scores from baseline to 6 months and 12 months will be evaluated.
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Baseline, 6 months, and 12 months
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Time to death (survival)
Časové okno: Baseline to 12 months
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Time from baseline to death within 12 months will be obtained from municipal electronic patient records.
Longer survival indicates a better outcome.
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Baseline to 12 months
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Health care utilization
Časové okno: 6 and 12 months
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Health care utilization will be assessed as a secondary outcome measure.
Data on nursing home admissions, municipal emergency service visits, and hospital admissions will be obtained from the Norwegian Registry for Primary Health Care and the Norwegian Patient Registry.
Health care utilization will be measured as the number of nursing home admissions, municipal emergency service visits, and hospital admissions during the 6- and 12-month follow-up periods.
Lower health care utilization indicates better outcomes.
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6 and 12 months
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Quality-Adjusted Life Years ( QALYs)
Časové okno: Baseline, 6 months and 12 months
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Quality-Adjusted Life Years (QALYs) will be a secondary outcome, measuring the combined effects of the intervention on survival and health-related quality of life.
QALYs will be calculated over the 12-month follow-up period by combining survival with health utility values derived from the EQ-5D.
Higher QALYs indicate better overall health outcomes.
QALY estimates will be used to inform cost-effectiveness analyses.
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Baseline, 6 months and 12 months
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Spolupracovníci a vyšetřovatelé
Sponzor
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Aktuální)
Primární dokončení (Odhadovaný)
Dokončení studie (Odhadovaný)
Termíny zápisu do studia
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
Další identifikační čísla studie
- 355225 (Jiné číslo grantu/financování: The Research Council Of Norway)
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