China Pilot of ICOPE (Integrated Care for Older People) in Chaoyang

Pinetree Health Technologies

Status: Completed

Conditions: Aging; Utilization, Health Care; Healthy Aging

Treatments: Other: Usual Care; Other: ICOPE

Study type: Interventional

Funder types: Other; Industry

Identifiers

NCT05933798

2020-QS-001

Details and patient eligibility

About

The goal of this pilot study is to examine predefined parameters (sample size, capacity building, acceptance by community-dwelling older people (participants) and care providers) to evaluate the feasibility of implementing World Health Organization's ICOPE (integrated care for older people) approach in China. The main questions it aims to answer are:

1. Whether it is feasible to implement the ICOPE approach in China;
2. Whether the integrated care approach would make any difference in health outcomes and resource utilization.

Participating older adults receiving integrated care (Intervention Group) are compared to those receiving usual care (Control Group) in order to answer the two questions above.

Full description

The goal of this pilot study is to evaluate the feasibility of implementing World Health Organization's ICOPE (integrated care for older people) approach in China. The main questions it aims to answer are:

1. Whether it is feasible to implement the ICOPE approach in China;
2. Whether the integrated care approach would make any difference in health outcomes and resource utilization.

For the first question, predefined parameters such as sample size, capacity building, acceptance by community-dwelling older people (participants) and care providers were examined.

Based on literature review and also as evidenced in the background study of the ICOPE guideline development process, a key hypothesis is that implementing integrated care management programs can improve health outcomes while containing costs.

According to the pilot study design, a total of 2000 community-dwelling older persons aged 60 and above at-risk of functional loss in Chaoyang District of Beijing are recruited and randomly assigned to the intervention group (n=500) and control group (n=1500).

Chaoyang is the most populated district in Beijing, with subdistricts that are urban, suburban and rural, well representing the city of Beijing. To identify potential participants who are at risk of functional loss, the pilot used ICOPE screening tools in the recruitment process, to screen for any losses in mobility, cognition, vitality, psychological health, vision and hearing.

Screening tools used are:

1. Independence is measured by the activities of daily living (ADL) 14-questionnaire scale.
2. Cognition is measured by mini-mental status examination (MMSE).
3. Vitality or nutrition is measured by by mini-nutritional assessment- short form (MNA-SF) to assess the risk of malnutrition.
4. Mobility is measured by short physical performance battery (SPPB).
5. Psychological health is measured by geriatric depression scale-five items (GDS-5).

Enrollment: 2,148 patients

Sex: All

Ages: 60+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Screened as positive for intrinsic capacity declines
• Decline in intrinsic capacity confirmed by in-depth assessment in any of the domains described as: MMSE < 27 (for cognition), SPPB ≤ 9 (for locomotion), MNA-SF <12 (for vitality we used nutrition as a proxy), GDS-5 ≥ 2 (for psychology we used depression as a proxy) or any vision impairment
• Signed form of consent and willingly participate in the pilot study

Exclusion criteria

• Negative results in their intrinsic capacity decline screening
• Severe hearing problems as the study was conducted during COVID-19 pandemics period and relied on telecare or remote sessions of intervention

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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2,148 participants in 2 patient groups

Intervention Group

Experimental group

Description:

Participants who were actively followed up during the study period with a personalized integrated care plan developed following the ICOPE screening and assessment, identified as "at-risk" for loss in intrinsic capacity.

Treatment:

Other: ICOPE

Control Group

Active Comparator group

Description:

Pariticpants who continued receiving usual care during the study period.

Treatment:

Other: Usual Care