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

University of Limerick

Status: Completed

Conditions: Frailty

Treatments: Other: SOLAR

Study type: Interventional

Funder types: Other

Identifiers

NCT04629690

SOLAR

Details and patient eligibility

About

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.

Full description

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.

Enrollment: 229 patients

Sex: All

Ages: 75+ years old

Volunteers: No Healthy Volunteers

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.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

---

229 participants in 2 patient groups

Control Arm

No Intervention group

Description:

The control group will obtain usual medical care in the Emergency Department and Acute Medical Assessment Unit

SOLAR arm

Experimental group

Description:

The SOLAR arm will obtain a comprehensive geriatric assessment which will be provided by a geriatric doctor, physiotherapist, occupational therapist, social worker, pharmacist and specialist nurse.

Treatment:

Other: SOLAR