CONNECARE-Assuta-Case Study 1
26 oktober 2017 uppdaterad av: Dr Bellaa Azria, Assuta Medical Center
Integrated Personalized Connected Care for Complex Chronic Patients - Community-based Management
The European Union's Horizon 2020 project issued a Call for Action [1] in December 2013 to design, develop, disseminate and evaluate new IT technologies for use in integrative treatment processes, with emphasis on complex adult patient. Assuta Hospital submitted a proposal for this call, as part of a broad consortium of 10 participants from various European countries.
The CONNECARE consortium has formulated a general model for integrative treatment, and is currently in the technological development stages, to create a smart (supportive decision) and adaptive system that supports integrative treatment processes both in the hospital and in the community for personalized treatment in complex chronic patients. The development includes a significant integrative component of self-care management by the patient and / or the primary caregiver.
Following the completion of the technological development, clinical trials will be held in four organizations throughout Europe - Assuta Hospital in Ashdod in cooperation with the Maccabi community in Ashdod, two centers in Catalonia and the Groningen region in the Netherlands. The purpose of the studies is to assess the impact of the implementation of the model, processes and digital tools that will be built during the project.
Studieöversikt
Status
Okänd
Betingelser
Intervention / Behandling
Detaljerad beskrivning
The intervention in this study consists of two parts:
- Integrative treatment in the community, which includes a close follow-up with a coordinating nurse for three months after discharge from the hospital.
- Empowering the patient to self-manage his or her health by using applications for smart devices.
The study protocol:
- Recruitment of participants during the patient's hospitalization after the patient is identified as a complex patient, explanation of the study and signing the consent form.
- Evaluation process for the patient, using valid questionnaires, in order to determine the baseline level at the entrance to the study.
- Distribution of research kit and related accessories and training.
- Close monitoring for three months in the community after discharge from the hospital and use of the research kit.
- Reassessment of the patient at the exit of the study.
Studietyp
Interventionell
Inskrivning (Förväntat)
220
Fas
- Inte tillämpbar
Kontakter och platser
Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.
Deltagandekriterier
Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.
Urvalskriterier
Åldrar som är berättigade till studier
65 år och äldre (Äldre vuxen)
Tar emot friska volontärer
Nej
Kön som är behöriga för studier
Allt
Beskrivning
Inclusion Criteria:
- All Maccabi members who arrive at the ER in an unplanned manner
- Age over 65
- Living in a home and not in a nursing home
- LACE> 7
At least three of the following conditions:
- Multiple drugs - regular use of four or more drugs
- More than one case of hospitalization or visit to the ER in the past year
- Malnutrition
- Elements of low socio-economic status
- The patient and / or the main caregiver speak Hebrew, English or Russian
- The patient or primary caregiver has a password to the Maccabi Online website
- The patient and / or the primary caregiver have basic technological knowledge in the use of the applications
- The patient has wireless Internet access at home (via Wifi or through a cellular connection)
Exclusion Criteria:
- Patients with cognitive or dementia problems
Studieplan
Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Hälsovårdsforskning
- Tilldelning: Icke-randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Ingen (Open Label)
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
|---|---|
|
Experimentell: Intervention group
Implementing the Connecare system to support integrated care for complex patients with an unplanned admission to Assuta Ashdod who are discharged back to the community with an emphasis on Connecare self managment system for the patient and close follow up and coordination of all of the medical, health and social care in the community by a Maccabi integrated care nurse for a period of 3 months post discharge.
|
The CONNECARE SMS will rely on a hybrid solution that, besides being autonomous (the patient may use the SMS to monitor and access to her/his data and information), has also a collaborative component (through the interaction with the SACM) to allow participation by clinicians and to provide feedback to them.
In so doing, the patient may control her/his activity, receiving recommendations to improve the treatment and to be encouraged in following it.
|
|
Inget ingripande: Matched control group
The control group will be selected from Maccabi's database and will be patients who are matched 1:1 with the intervention sample and live in another community similar to Ashdod in socioeconomic characteristics who undergo the same elective major surgery in other hospitals
|
Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Re-Hospitalizations and emergency room visits in the short term after discharge from the hospital
Tidsram: One month
|
Number of hospitalizations and emergency room visits after discharge
|
One month
|
|
Re-Hospitalizations and emergency room visits in the long term after discharge from the hospital
Tidsram: One year
|
Number of hospitalizations and emergency room visits after discharge
|
One year
|
|
Length of hospitalization
Tidsram: Less then one month
|
In days
|
Less then one month
|
Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Compliance with the assignments in the discharge program guidelines
Tidsram: One year
|
At the time of discharge from the hospital, the patient receives a list of tasks to be performed as part of the release letter.
We would like to know how many out of this tasks were carried out
|
One year
|
|
Community health services use
Tidsram: One year
|
Number of appointments made by the patient during the follow up time for primary physician, professionals, laboratory tests and imaging, physiotherapy and nutritionist.
|
One year
|
|
Evaluation of usability of the technology systems developed
Tidsram: One year
|
Using questionnaires for nurses and patients to express their opinion on the use of the technology systems in the project and how much these systems assisted them
|
One year
|
|
Cost-benefits evaluation for the intervention
Tidsram: One year
|
Economic evaluation of tests and services saved as a result of active and orderly monitoring of the patient
|
One year
|
|
Assessment of satisfaction of patients from all the projects components (The follow up and the technology systems)
Tidsram: One year
|
Using satisfaction questionnaires to be passed at the end of the study
|
One year
|
|
Assessment of satisfaction of medical staff from all the projects components (The follow up and the technology systems)
Tidsram: One year
|
Using satisfaction questionnaires to be passed at the end of the study
|
One year
|
Samarbetspartners och utredare
Det är här du hittar personer och organisationer som är involverade i denna studie.
Sponsor
Samarbetspartners
Utredare
- Studierektor: Bella Azaria, Doctor, Assuta Medical Center
Publikationer och användbara länkar
Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.
Användbara länkar
Studieavstämningsdatum
Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.
Studera stora datum
Studiestart (Förväntat)
1 februari 2018
Primärt slutförande (Förväntat)
1 februari 2019
Avslutad studie (Förväntat)
1 februari 2019
Studieregistreringsdatum
Först inskickad
23 oktober 2017
Först inskickad som uppfyllde QC-kriterierna
26 oktober 2017
Första postat (Faktisk)
31 oktober 2017
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
31 oktober 2017
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
26 oktober 2017
Senast verifierad
1 oktober 2017
Mer information
Termer relaterade till denna studie
Ytterligare relevanta MeSH-villkor
Andra studie-ID-nummer
- 0033-17-ASMC
Plan för individuella deltagardata (IPD)
Planerar du att dela individuella deltagardata (IPD)?
NEJ
Läkemedels- och apparatinformation, studiedokument
Studerar en amerikansk FDA-reglerad läkemedelsprodukt
Nej
Studerar en amerikansk FDA-reglerad produktprodukt
Nej
Denna information hämtades direkt från webbplatsen clinicaltrials.gov utan några ändringar. Om du har några önskemål om att ändra, ta bort eller uppdatera dina studieuppgifter, vänligen kontakta register@clinicaltrials.gov. Så snart en ändring har implementerats på clinicaltrials.gov, kommer denna att uppdateras automatiskt även på vår webbplats .