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Change in study design
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The MidWest multidisciplinary Community Intervention Teams (MD-CIT) comprise of specialist, healthcare teams that provide a rapid and integrated response to a patient with an acute episode of illness who requires enhanced services/acute intervention for a defined short period of time in the MidWest of Ireland. This is provided in the patient's home, thereby facilitating early discharge from the acute hospital setting.
The investigators are performing an evaluation of the MDCIT service provided to older adults admitted to UL Hospitals Group. The investigators will assess patients in hospital, at 30 days and at a six months.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| MDCIT Intervention | Other | The MidWest Multidisciplinary Community Intervention Teams (MDCIT) comprise of specialist, healthcare teams that provide a rapid and integrated response to a patient with an acute episode of illness who requires enhanced services/acute intervention for a defined short period of time. This is provided in the patient's home after an acute hospital admission, thereby facilitating early discharge. The MDCIT intervention is composed of occupational therapy, physiotherapy, and healthcare assistants, with nursing support as required. The MDCIT therapists aim to make their first visit to patients within 24-48 hours of hospital discharge. Patients receive two-three visits per week, over a period of two to four weeks dependant on the patient's rehabilitation needs. Upon discharge from the MDCIT service, patients can be referred to community services as indicated by therapists. |
| Measure | Description | Time Frame |
|---|---|---|
| Functional Ability | Function will be measured using the Barthel Index (BI). The BI scores a patient from 0-20, with a higher score indicating greater independence. | This will be measured at baseline. |
| Functional Ability | Function will be measured using the Barthel Index (BI). The BI scores a patient from 0-20, with a higher score indicating greater independence. | This will be measured at 30 days. |
| Functional Ability | Function will be measured using the Barthel Index (BI). The BI scores a patient from 0-20, with a higher score indicating greater independence. | This will be measured at 180 days. |
| Measure | Description | Time Frame |
|---|---|---|
| Frailty Score | Frailty will be measured using the Clinical Frailty Scale (CFS). The CFS screens for frailty in older adults, with a minimum score of 1 considered least frail and a maximum score of 9 indicating severe frailty. | This will be measured at baseline. |
| Frailty Score |
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Inclusion Criteria:
Exclusion Criteria:
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Older adults admitted to general medical and surgical wards, trauma/orthopaedic wards and acute medical assessment units and subsequently discharged home with MDCIT support will be included.
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| Name | Affiliation | Role |
|---|---|---|
| Cathryn Ryan | MidWest Community Healthcare | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Hospital Limerick | Limerick | V94 T9PX | Ireland |
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Frailty will be measured using the Clinical Frailty Scale (CFS). The CFS screens for frailty in older adults, with a minimum score of 1 considered least frail and a maximum score of 9 indicating severe frailty. |
| This will be measured at 30 days. |
| Frailty Score | Frailty will be measured using the Clinical Frailty Scale (CFS). The CFS screens for frailty in older adults, with a minimum score of 1 considered least frail and a maximum score of 9 indicating severe frailty. | This will be measured at 180 days. |
| Patient Quality of Life | Quality of Life will be measured using the EQ-5D-5L. This questionnaire asks a patient to rate their overall perceived health from a scale of 0-100 (0 = very poor; 100 = excellent). | This will be measured at baseline. |
| Patient Quality of Life | Quality of Life will be measured using the EQ-5D-5L. This questionnaire asks a patient to rate their overall perceived health from a scale of 0-100 (0 = very poor; 100 = excellent). | This will be measured at 30 days. |
| Patient Quality of Life | Quality of Life will be measured using the EQ-5D-5L. This questionnaire asks a patient to rate their overall perceived health from a scale of 0-100 (0 = very poor; 100 = excellent). | This will be measured at 180 days. |
| Quality of Care | Quality of Care will be measured using the Patient Assessment of Integrated Elderly Care. Patients are asked 20 questions across a Likert scale from 'none at all' to 'always.' | This will be measured at 30 days. |
| Quality of Care | Quality of Care will be measured using the Patient Assessment of Integrated Elderly Care. Patients are asked 20 questions across a Likert scale from 'none at all' to 'always.' | This will be measured at 1800 days. |
| Unscheduled ED Attendance(s) | ED hospital databases will be searched to identify ED attendances. | This will be measured at 30 days. |
| Unscheduled ED Attendance(s) | ED software will be searched to identify ED attendances. | This will be measured at 180 days. |
| Unscheduled Hospital Admission(s) | ED and hospital software will be searched to identify admissions. | This will be measured at 30 days. |
| Unscheduled Hospital Admission(s) | ED and hospital software will be searched to identify admissions. | This will be measured at 180 days. |
| Nursing Home Admission(s) | Hospital software will be searched to identify patients admitted to nursing homes. | This will be measured at 30 days. |
| Nursing Home Admission(s) | Hospital software will be searched to identify patients admitted to nursing homes. | This will be measured at 180 days. |
| Mortality | Hospital software will be searched to identify patients who pass away. | This will be measured at 30 days. |
| Mortality | Hospital software will be searched to identify patients who pass away. | This will be measured at 180 days. |