Home-based Longitudinal Investigation of the Multidisciplinary Team Integrated Care (HOLISTIC)
29 de janeiro de 2020 atualizado por: Chao A. Hsiung, National Health Research Institutes, Taiwan
Developing Innovative Models for Health & Long-term Care Facilities and Technology Services: Prospective Cohort Study for Home Health Care
Some research found the effectiveness of implementation of home health care on patients' physical function, quality of life (QoL) and decreased the risk of hospitalization and medical costs.
However, little was known about the longitudinal change of comprehensive assessments of physical and mental health, QoL, well-being, and medical resource utilization of patients receiving home health care and their caregivers.
Furthermore, the evaluation of advance care planning, palliative care need, and the quality of dying and death were also insufficient among the aforementioned population.
Therefore, this cohort study aims to investigate the longitudinal change of health-related outcomes and utilization of resource utilization, and explore their trajectories in two years for patients who receive home health care and their caregivers in Taiwan.
Visão geral do estudo
Status
Desconhecido
Descrição detalhada
This is a prospective longitudinal cohort study in Taiwan. Data will be collected by trained interviewers at the baseline (T0), 3-month follow-up (T1), 6-month follow-up (T2), 12-month follow-up (T3), 18-month follow-up (T4), and 24-month follow-up (T5). Via home visits, interviewer-administered questionnaires (informed consent, contact/follow-up information, background information, health condition, physical functioning, cognitive function, etc.) will be used. It estimates that the home visit will take up to 2 hours.
The investigators will recruit at least 1200 eligible patients and caregivers (600 dyads) from at least 15 institutions (e.g., home clinics and hospitals) which provide home health care. Trained research assistants will touch based with eligible participants recommended by institution staff and invite them to take part in the study. To ensure the study are achieving the target sample the investigators will examine the distribution of living area and number of participants in each type of home health care unit during recruiting. Moreover, the investigators have estimated an attrition rate of 20% over the study. Higher drop-off rates in certain sub-groups may be problematic, so the investigators will monitor participants' attrition.
In addition, the cohort the investigators enrolled will be linked to their data in Taiwan's National Health Insurance Research Database to analyze the medical resource utilization of participants in our study. The results will show the health status and resource utilization as well as quality of home health care in Taiwan for clinical practices, research and future policy making.
Tipo de estudo
Observacional
Inscrição (Antecipado)
1200
Contactos e Locais
Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.
Locais de estudo
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Miaoli County
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Zhunan, Miaoli County, Taiwan, 35053
- Chao A. Hsiung
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Critérios de participação
Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.
Critérios de elegibilidade
Idades elegíveis para estudo
20 anos e mais velhos (Adulto, Adulto mais velho)
Aceita Voluntários Saudáveis
Sim
Gêneros Elegíveis para o Estudo
Tudo
Método de amostragem
Amostra Não Probabilística
População do estudo
patients with home health care and their caregivers
Descrição
Inclusion Criteria:
- Aged 20 years or older
- Receiving home health care services at least two months
- Either the patient or caregiver can express clearly
Exclusion Criteria:
- Reject to sign the informed consent
- Both the patient and caregiver cannot complete the interview
- Both the patient and caregiver cannot communicate with an interviewer in a familiar language
Plano de estudo
Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.
Como o estudo é projetado?
Detalhes do projeto
Coortes e Intervenções
Grupo / Coorte |
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patient
patients who receive home health care
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caregiver
caregivers who take care of patients with home health care
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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
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Change from ability to perform activities of daily living (ADL) at two years
Prazo: Baseline, 3-month follow-up, 6-month follow-up, 12-month follow-up, 18-month follow-up, 24-month follow-up
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The Barthel Index will be adapted to assess ADL.
The total score ranges from 0 to 100, with 100 indicating full independence in doing daily activities.
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Baseline, 3-month follow-up, 6-month follow-up, 12-month follow-up, 18-month follow-up, 24-month follow-up
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Change from frailty at two years
Prazo: Baseline, 3-month follow-up, 6-month follow-up, 12-month follow-up, 18-month follow-up, 24-month follow-up
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It will be measured by the 9-point Clinical Frailty Scale (CFS).
The total score ranges from 1 to 9, with 7 or higher indicating severe frailty, even being terminally ill.
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Baseline, 3-month follow-up, 6-month follow-up, 12-month follow-up, 18-month follow-up, 24-month follow-up
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Change from cognitive function/memory at two years
Prazo: Baseline, 3-month follow-up, 6-month follow-up, 12-month follow-up, 18-month follow-up, 24-month follow-up
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It will be measured by the Brain Health Test (Chinese version) via testing the orientation to time, immediate and delayed recall of five items, categorical verbal fluency test.
The total score ranges from 0 to 16, with higher scores indicating worse cognitive impairment.
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Baseline, 3-month follow-up, 6-month follow-up, 12-month follow-up, 18-month follow-up, 24-month follow-up
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Change from percentage of participants with Dementia at two years
Prazo: Baseline, 3-month follow-up, 6-month follow-up, 12-month follow-up, 18-month follow-up, 24-month follow-up
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The Functional Assessment Staging Test (FAST) will be adapted to assess an individual's stage of Alzheimer's disease.
It includes seven stages from normal aging to sever Dementia.
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Baseline, 3-month follow-up, 6-month follow-up, 12-month follow-up, 18-month follow-up, 24-month follow-up
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Change from mean score of depression at two years
Prazo: Baseline, 3-month follow-up, 6-month follow-up, 12-month follow-up, 18-month follow-up, 24-month follow-up
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It will be measured by the 5-item Geriatric Depression Scale (GDS).
The total score ranges from 0 to 5, with higher scores indicating more depression.
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Baseline, 3-month follow-up, 6-month follow-up, 12-month follow-up, 18-month follow-up, 24-month follow-up
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Change from neuropsychiatric status at two years
Prazo: Baseline, 3-month follow-up, 6-month follow-up, 12-month follow-up, 18-month follow-up, 24-month follow-up
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It will be measured by the Neuropsychiatric Inventory.
The 10 sub-domains of behavioral functioning are examined, including delusions, hallucinations, agitation/aggression, dysphoria, anxiety, euphoria, apathy, disinhibition, irritability/lability, and aberrant motor activity syndrome.
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Baseline, 3-month follow-up, 6-month follow-up, 12-month follow-up, 18-month follow-up, 24-month follow-up
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Change from quality of life (QOL) at two years
Prazo: Baseline, 3-month follow-up, 6-month follow-up, 12-month follow-up, 18-month follow-up, 24-month follow-up
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We will adapt the Quality of Life in Alzheimer's Disease (QOL-AD) scale for patients with cognitive impairment, and Quality of Life Survey for Home Care (QOL-HC) scale for those without cognitive impairment.
The total score of QOL-AD ranges from 13 to 52, with higher values indicating a higher QoL.
The total score of QOL-HC ranges from 0 to 8, with higher values indicating a higher QoL.
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Baseline, 3-month follow-up, 6-month follow-up, 12-month follow-up, 18-month follow-up, 24-month follow-up
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Change from mental wellbeing at two years
Prazo: Baseline, 3-month follow-up, 6-month follow-up, 12-month follow-up, 18-month follow-up, 24-month follow-up
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It will be measured by the World Health Organization- Five Well-Being Index (WHO-5).
The raw score ranges from 0 to 25, 0 representing worst possible and 25 representing best possible quality of life.
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Baseline, 3-month follow-up, 6-month follow-up, 12-month follow-up, 18-month follow-up, 24-month follow-up
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Shared decision making (SDM)
Prazo: Two years
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It will be measured by the Decision-making Participation Self-Efficacy Scale (DEPS).
The total score ranges from 5 to 25, with higher scores indicating higher self-efficacy.
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Two years
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Advance Care Planning (ACP)
Prazo: Two years
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It will be measured by the 4-question version of UCSF-ACP with the Process Measures (knowledge, contemplation, self-efficacy, and readiness, 5-point Likert scales) and Action Measures (yes/no whether an ACP behavior is completed).
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Two years
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Change from Nutrition status at two years
Prazo: Baseline, 3-month follow-up, 6-month follow-up, 12-month follow-up, 18-month follow-up, 24-month follow-up
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It will include the Mini Nutritional Assessment (MNA).
The total score of MNA ranges from 0-14, with more than 11 indicating normal nutrition status.
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Baseline, 3-month follow-up, 6-month follow-up, 12-month follow-up, 18-month follow-up, 24-month follow-up
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Change from risk for pressure injury at two years
Prazo: Baseline, 3-month follow-up, 6-month follow-up, 12-month follow-up, 18-month follow-up, 24-month follow-up
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It will be measured by the sale of Braden Scale for Predicting Pressure Sore Risk.
The scale is composed of six subscales that reflect sensory perception, skin moisture, activity, mobility, friction and shear, and nutritional status.
The total score ranges from 6 to 23, with higher scores indicating lower risk for forming pressure sores.
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Baseline, 3-month follow-up, 6-month follow-up, 12-month follow-up, 18-month follow-up, 24-month follow-up
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Needs assessment for supportive & palliative care
Prazo: Two years
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It will be measured by the Supportive & Palliative Care Indicators Tool (SPICT).
Following the guideline, the Chinese version will be developed before the cohort study starts.
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Two years
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Change from medical resource utilization at two years
Prazo: Baseline, 3-month follow-up, 12-month follow-up, 24-month follow-up
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Assessments include medical costs and out-of-pocket costs regarding utilization of medical resource and home health care.
The used scales are developed by our research team.
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Baseline, 3-month follow-up, 12-month follow-up, 24-month follow-up
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Change from caregiving burden at two years
Prazo: Baseline, 3-month follow-up, 6-month follow-up, 12-month follow-up, 18-month follow-up, 24-month follow-up
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It will be measured by the revised version of Zarit Burden interview containing 22 items, with higher scores indicating greater burden.
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Baseline, 3-month follow-up, 6-month follow-up, 12-month follow-up, 18-month follow-up, 24-month follow-up
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Change from number of used chronic disease drug at two years
Prazo: Baseline, 3-month follow-up, 6-month follow-up, 12-month follow-up, 18-month follow-up, 24-month follow-up
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It will be measured by two items which are developed by our research team.
Based on patients' prescriptions, they will be required to answer the number of chronic disease drug they used and these drugs' information, including the names, administrations and dosages.
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Baseline, 3-month follow-up, 6-month follow-up, 12-month follow-up, 18-month follow-up, 24-month follow-up
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Colaboradores e Investigadores
É aqui que você encontrará pessoas e organizações envolvidas com este estudo.
Patrocinador
Colaboradores
Investigadores
- Diretor de estudo: Chao A. Hsiung, PhD, National Health Research Institutes, Taiwan
- Investigador principal: Sang-Ju Yu, MD, Taiwan Society of Home Health Care and Home Clinic Dulan
- Investigador principal: Ping-Jen Chen, MD, Kaohsiung Medical University
Publicações e links úteis
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Datas de registro do estudo
Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.
Datas Principais do Estudo
Início do estudo (Real)
20 de novembro de 2019
Conclusão Primária (Real)
20 de novembro de 2019
Conclusão do estudo (Antecipado)
31 de dezembro de 2022
Datas de inscrição no estudo
Enviado pela primeira vez
15 de janeiro de 2020
Enviado pela primeira vez que atendeu aos critérios de CQ
29 de janeiro de 2020
Primeira postagem (Real)
31 de janeiro de 2020
Atualizações de registro de estudo
Última Atualização Postada (Real)
31 de janeiro de 2020
Última atualização enviada que atendeu aos critérios de controle de qualidade
29 de janeiro de 2020
Última verificação
1 de janeiro de 2020
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
- EC1080203
Plano para dados de participantes individuais (IPD)
Planeja compartilhar dados de participantes individuais (IPD)?
NÃO
Informações sobre medicamentos e dispositivos, documentos de estudo
Estuda um medicamento regulamentado pela FDA dos EUA
Não
Estuda um produto de dispositivo regulamentado pela FDA dos EUA
Não
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