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Trial registered on ANZCTR
Registration number
ACTRN12608000202369
Ethics application status
Approved
Date submitted
15/04/2008
Date registered
16/04/2008
Date last updated
18/12/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
Preventing hospital readmissions and loss of functional ability in high risk older adults: a randomised controlled trial
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Scientific title
An evaluation of the effectiveness of transitional care interventions, (including individual exercise programs, comprehensive discharge planning, and home and telephone follow-up care for 24 weeks from discharge) in preventing hospital readmissions and loss of functional ability in older adults at high risk of hospital readmission: a randomised controlled trial
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Secondary ID [1]
283187
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
Rio2
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Hospital readmissions and loss of functional ability in older adults at high risk of hospital readmission
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Condition category
Condition code
Physical Medicine / Rehabilitation
3196
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0
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Other physical medicine / rehabilitation
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Intervention 1. Gerontic Nurse (GN) comprehensive assessment within 72 hours of hospital admission, discharge planning, home visit within 72 hours from discharge, telephone follow-up care weekly for 4 weeks then monthly for 24 weeks post-discharge.
Intervention 2. Physiotherapist comprehensive assessment within 72 hours of hospital admission, individualised exercise program commencing within 72 hours of hospital admission.
Intervention 3. Gerontic Nurse (GN) and Physiotherapist comprehensive assessment within 72 hours of hospital admission, individualised exercise program commencing within 72 hours of hospital admission, discharge planning (GN), home visit within 72 hours from discharge (GN), telephone follow-up care weekly for 4 weeks then monthly for 24 weeks post-discharge (GN).
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Intervention code [1]
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Prevention
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Comparator / control treatment
Standard Treatment: routine assessments, discharge planning and follow-up care undertaken and organised by hospital staff. This follow-up care involves a follow-up appointment with either the hospital Outpatients Department Medical clinic, or their local General Practitioner, organisation of 'Home Help' (assistance with shopping and housework, Meals-on-Wheels) community services if the patient fits the criteria, and organisation of community nursing services and/or allied health services (e.g. physiotherapy, occupational therapy) if the patient has particular needs for these types of care following discharge.
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Control group
Active
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Outcomes
Primary outcome [1]
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Hospital readmissions and unplanned health service use (Emergency Department visits, emergency visits to General Practitioners or other health professionals)
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Assessment method [1]
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Timepoint [1]
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4 weeks, 12 weeks and 24 weeks from discharge from hospital
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Primary outcome [2]
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Functional Ability, as measured with Instrumental Activities of Daily Living Scale, Activities of Daily Living Scae, and Walking Impairment Questionnaire (Modified)
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Assessment method [2]
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Timepoint [2]
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On admission to the study, then 4 weeks, 12 weeks, and 24 weeks following hospital discharge
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Primary outcome [3]
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Cost effectiveness, using measures of cost of care, cost of unplanned health service use, costs related to decreased functional ability and loss of independence in activities of daily living
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Assessment method [3]
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Timepoint [3]
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On admission to the study (baseline), 4 weeks, 12 weeks and 24 weeks from hospital discharge
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Secondary outcome [1]
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Quality of Life, using the SF-12v2
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Assessment method [1]
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Timepoint [1]
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On admission to the study, 4 weeks, 12 weeks, and 24 weeks from hospital discharge
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Secondary outcome [2]
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Physical strength and endurance, measured with grip strength, Timed Get Up and Go Test, Berg Balance Scale, 6 metre walk test
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Assessment method [2]
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Timepoint [2]
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On admission to the study, 4 weeks, 12 weeks and 24 weeks from hospital dishcarge
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Secondary outcome [3]
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Psychosocial outcomes, as measured with the Geriatric Depression Scale, Medical Outcomes Study Social Support Scale and Chronic Disease Self-Efficacy Scales
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Assessment method [3]
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Timepoint [3]
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On admission to the study, then 4 weeks, 12 weeks and 24 weeks from hospital discharge
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Eligibility
Key inclusion criteria
1. Aged 65 years or older
2. Admitted to a hospital wards with a medical (i.e. non-surgical) diagnosis
3. Have at least one of the following known risk factors for hospital readmission:
a. aged 75 years or older
b. live alone
c. poor social support available at home
d. 2 or more hospital admissions within the previous 6 months
e. previous hopsitalisation in the past 30 days
f. moderate to severe functional impairment
g. history of depression
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Minimum age
65
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Unable to be contacted via telephone
2. Resident of a high care nursing home
3. Unable to speak or understand English
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Prior to commencement of the study a randomisation allocation sequence will be generated with a computerised randomisation program. A staff member not working on this project will then fill sealed opaque envelopes with the allocation sequence. A Research Assistant at the clnical site will determine if the patient is elibible for inclusion in the trial, then obtain informed consent and collect baseline data. THe research assistant will then open the sealed envelope to determine the participant's allocated group.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computerised sequence generation
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
21/04/2008
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Actual
24/04/2008
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Date of last participant enrolment
Anticipated
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Actual
28/10/2010
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Date of last data collection
Anticipated
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Actual
14/04/2011
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Sample size
Target
328
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Accrual to date
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Final
222
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Recruitment in Australia
Recruitment state(s)
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Recruitment postcode(s) [1]
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4101
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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ARC Discovery Projects Grant
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Address [1]
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Australian Research Council
1st Floor
8 Brindabella Circuit
Brindabella Business Park
Canberra Airport ACT 2609
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
Professor Mary Courtney
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Address
Professor M. Courtney
Faculty of Health
Queensland University of Technology
Victoria Park Rd
Kelvin Grove QLD 4059
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Country
Australia
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Secondary sponsor category [1]
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Individual
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Name [1]
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Professor Helen Edwards
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Address [1]
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Professor H. Edwards
School of Nursing
Queensland University of Technology
Victoria Park Rd
Kelvin Grove QLD 4059
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Country [1]
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Australia
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Other collaborator category [1]
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Hospital
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Name [1]
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Professor Anne Chang, Mater Health Services
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Address [1]
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Professor Anne Chang
Centre for Nursing Research
Mater Health Services
Raymond Tce
South Brisbane QLD 4101
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Country [1]
261
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Mater Health Services Human Research Ethics Committee
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Ethics committee address [1]
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Human Research Ethics Committee Mater Health Services Raymond Terrace South Brisbane QLD 4101
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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Approval date [1]
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03/04/2008
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Ethics approval number [1]
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Ref. No. 1173A
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Summary
Brief summary
Older people have higher rates of hospital admission than the general population and higher rates of readmission due to complications and falls. During hospitalisation, older people experience significant functional decline which impairs their future independence and quality of life. Current models of discharge planning and follow-up care do not address the need to prevent deconditioning or functional decline. This study aims to compare the effectiveness of innovative strategies including exercise and/or in-home and telephone follow-up for community-based older people at risk of readmission. Results will determine effective strategies to reduce readmissions and improve functional status, independence and psycho-social well-being
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Trial website
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Trial related presentations / publications
Courtney M, Chang AM, Edwards H, Parker A, Finlayson K. (2013) Transitional care interventions reduce emergency hospital readmissions in older adults. Sigma Theta Tau International 24th International Nursing Research Congress, 22-26 July 2013, Prague, Czech Republic Courtney M, Edwards H, Chang AM, Parker AW, Finlayson K, Hamilton K. (2011) A randomised controlled trial to prevent hospital readmissions and loss of functional ability in high risk older adults: a study protocol. BMC Health Services Research, 11:202, doi:1186/1472-6963-11-202
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Public notes
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Contacts
Principal investigator
Name
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Prof Anne Chang
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Address
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School of Nursing
Queensland University of Technology
Victoria Park Rd
Kelvin Grove
Qld, 4059
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Country
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Australia
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Phone
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+61 0731383842
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Anne Chang
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Address
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Faculty of Health
Queensland University of Technology
Victoria Park Rd
Kelvin Grove QLD 4059
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Country
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Australia
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Phone
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+61 7 31383842
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Fax
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+61 7 31383814
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Email
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[email protected]
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Contact person for scientific queries
Name
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Anne Chang
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Address
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Faculty of Health
Queensland University of Technology
Victoria Park Rd
Kelvin Grove QLD 4059
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Country
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Australia
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Phone
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+61 7 31393842
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Fax
2608
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+61 7 31383814
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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