Geriatric-CO-mAnagement for Cardiology Patients in the Hospital (G-COACH)

Universitaire Ziekenhuizen KU Leuven

Status: Completed

Conditions: Geriatric Assessment; Length of Stay; Delirium; Health Services for the Aged; Cardiovascular Diseases; Activities of Daily Living; Frail Elderly

Treatments: Other: Cardio-geriatric co-management

Study type: Interventional

Funder types: Other

Identifiers

NCT02890927

22/15/028

Details and patient eligibility

About

The primary objective of the evaluation study is to determine if geriatric co-management is superior to standard of care in preventing functional decline in older patients admitted for acute heart disease or Transcatheter Aortic Valve Implementation (TAVI) to the cardiology units of the University Hospitals Leuven.

Full description

This study aims to implement and evaluate a geriatric co-management intervention in older patients admitted for acute heart disease or Transcatheter Aortic Valve Implementation (TAVI) to the cardiology units of the University Hospitals Leuven. The study uses a mixed-methods methodology aiming to 1) assess the feasibility and evaluate the effectiveness of geriatric co-management, 2) describe the experiences of intervention participants, and 3) perform a process evaluation. We will first consecutively recruit patients on the cardiology units to measure the standard of care in the control group. The geriatric co-management intervention will then be implemented and piloted on the participating units. Once fully implemented, we will consecutively recruit patients for the intervention group who will receive the geriatric co-management intervention.

Enrollment: 454 patients

Sex: All

Ages: 75+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria: Patients will be included if they:

• Are admitted for non-surgical treatment of an acute heart problem (patients may be admitted through the emergency department or the cardiology outpatient services for any heart related acute disease) OR if they are admitted for Transcatheter Aortic Valve Implantation (TAVI);
• Are aged 75 years or older;
• Have an expected length of stay of three days or longer;
• Non-palliative on hospital admission
• Are Dutch speaking and testable;
• Give informed consent or proxy-informed consent;

Exclusion Criteria: Patients will be excluded if they:

• Are admitted from another hospital unit or other hospital;
• Have been admitted to the intensive care unit for three days or longer;

Trial design

Primary purpose: Health Services Research

Allocation: Non-Randomized

Interventional model: Sequential Assignment

Masking: None (Open label)

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454 participants in 2 patient groups

Cardio-geriatric co-management

Experimental group

Description:

A geriatric co-management intervention will be implemented on the cardiology units of the University Hospitals Leuven. Geriatric co-management is defined as a shared responsibility and decision making between the cardiology team and the geriatric team who provides complementary medical care in the prevention and management of geriatric problems. Patients included in the co-management program will undergo a comprehensive geriatric assessment within 24 hours of hospital admission.

Treatment:

Other: Cardio-geriatric co-management

Standard of care

No Intervention group

Description:

The control group will receive the standard of care on the cardiology units. This includes multidisciplinary care with a one weekly multidisciplinary team meeting. Team members include a cardiology resident (supervised by a cardiologist), ward nurses, a physical therapist, a social worker and a dietician. A geriatric consultation team is available for consultation services if requested by the cardiology team.