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Completed

NCT Number: NCT04629690

SOLAR- Frailty Screening and Multidisciplinary Assessment of Older Adults in the Emergency Department

SOLAR is a randomised control trial exploring the role of Comprehensive Geriatric Assessment (CGA) in older adults who screen positive for frailty based on the Identification of Seniors at Risk (ISAR) tool the the Emergency Department and Acute Medical Assessment Unit of a University Teaching Hospital.

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Key information

Conditions

Frailty Disease Attributes Emergencies Pathologic Processes Pathological Conditions, Signs and Symptoms

Age range

75 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

University Hospital Limerick

Limerick, v, Ireland

About this study

All patients who are over seventy-five will be screened for frailty using the widely used ISAR tool. Those with a score of 2 or above in the ISAR will be randomised. The treatment arm will undergo geriatric medicine team-directed CGA from admission to Emergency Department (ED) or Acute Medical Assessment Unit (AMAU) whereby the non-treatment arm will undergo usual patient care. A dedicated multidisciplinary team of a geriatric medicine trainee, physiotherapist, occupational therapist and medical social worker will carry out the assessment, as well as interventions that arise from that assessment. Primary outcomes will be time from triage to decision to admit or discharge. Secondary Outcomes will be subsequent Emergency Department reattendance, rehospitalisation, functional decline and mortality at 30 days and 180 days. This will be recorded by telephone consultation and electronic records.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Older adults aged 75 years or over
  • Medically stable as deemed by the treating physician
  • A score of 2 or above on the ISAR
  • Present with a medical complaint

Exclusion criteria

  • Those under the age of 75 years
  • A score of less than 2 on the ISAR
  • Acute myocardial infarction, stroke or non-medical problems e.g. surgical or psychiatric issues
  • Patients who are medically unstable
  • If neither the patient nor carer can communicate in English sufficiently to complete consent or baseline assessment
  • Confirmed or highly suspicious of symptoms for COVID 19.

Treatment and study plan

SOLAR

Other

The participants will obtain a multidisciplinary assessment regarding their medical conditions, medication review, cognitive assessment, functional assessment, gait and balance assessment by senior clinicians and a management plan will be implemented.

Other names: Comprehensive Geriatric Assessment

Primary outcomes

  1. Patient Experience Times (PET)

    Time frame: Exact time of admission or discharge from ED will be collected at 30 days from index visit

    PET time recorded as time of arrival at the ED to discharge or admission

  2. Time to admission or discharge and if for admission, time that the bed is booked to go to medical wards.

    Time frame: Exact time of admission or discharge from ED will be collected at 30 days from index visit

    This is the time that the patient is either discharged or identified for admission and bed booked to go to the medical wards

Secondary outcomes

  1. Rate of ED Representation

    Time frame: 30 days and 6 months

    A record of the patient coming back to the ED within 30 days and/or 6 months

  2. Mortality

    Time frame: 30 days and 6 months

    A record of the patient having died within 30 days or 6 months

  3. Rate of Hospital Readmission

    Time frame: 30 days and 6 months

    A record of the patient requiring admission to the hospital within 30 days or 6 months

  4. Functional Decline

    Time frame: 30 days and 6 months

    As determined by the Barthel Index. Barthel Index is a score from 0-20. A score of 0 is completely dependent, 20 is fully independent.

  5. Patient Satisfaction-

    Time frame: 30 days

    As determined by the Patient Satisfaction Survey III Short Form (PSQ18). This is scored from 18 to 90. 18 being the worst score and 90 being the best score.

  6. Patient Quality of Life

    Time frame: 30 days

    As determined by the Euro Quality of Life (Qol) EQ5D. Scored from 0 to 100. 0 is worst imaginable health state with 100 being the best imaginable health state

  7. Number of visits to family doctor, therapists or public health nurse

    Time frame: 30 days and 6 months

    Determined by self reported visits to family doctor, allied health services or Public Health Nurse. There will be a telephone consultation at 30 days and 6 months where patients will be asked if they have visited a family doctor, therapist or public health nurse in the previous 30 days at the 30 day telephone call, or 6 months at the 6 month phone call.

Sponsors and collaborators

Lead sponsor

University of Limerick

Other

Collaborators

  • University Hospital of Limerick

Registry information

Official study title

The Impact of Frailty Screening of Older Adults With muLtidisciplinary Assessment of Those At Risk During Emergency Hospital Attendance on the Quality, Safety and Cost-effectiveness of Care (SOLAR): a Randomised Controlled Trial

Acronym: SOLAR

Important dates

Study start
2020
Primary completion
2021
Study completion
2023
First posted
Nov 16, 2020
Registry last updated
Jun 13, 2023

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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