Telehealth for Residential Aged Care Facilities: A Pragmatic Controlled Trial

• Register: ANZCTR
• Last refreshed on: 13 January 2020
• Main ID: ACTRN12614000913673
• Date of registration: 27/08/2014
• Prospective Registration: Yes
• Primary sponsor: The University of Queensland
• Public title: Telehealth for Residential Aged Care Facilities: A Pragmatic Controlled Trial
• Scientific title: In new residents in long term care facilities, does a telehealth service providing geriatric consultation, compared to usual care, improve health outcomes
• Date of first enrolment: 01/09/2014
• Target sample size: 880
• Recruitment status: Not yet recruiting
• URL: https://anzctr.org.au/ACTRN12614000913673.aspx
• Study type: Interventional
• Study design: Purpose: Prevention; Allocation: Randomised controlled trial; Masking: Open (masking not used);Assignment: Parallel;Type of endpoint: Efficacy;
• Phase: Not Applicable

Countries of recruitment

Australia

Contacts

• Name: Dr Melinda Martin-Khan

• Name: Dr Melinda Martin-Khan

Key inclusion & exclusion criteria

Inclusion criteria: Residents of long term care facilities (or residential care facility)
Referred by GP
Exclusion criteria: Resident (or secondary decision maker) unable to give consent
No referral from GP or nurse practitioner received

Age minimum: No limit
Age maximum: No limit
Gender: Both males and females

Health Condition(s) or Problem(s) studied

Mental Health - Studies of normal psychology, cognitive function and behaviour

Cognitive Function;Ageing;
Cognitive Function
Ageing

Public Health - Health service research

Intervention(s)

A comprehensive geriatric assessment will be carried out via videoconferencing. The geriatric consultation is a direct interaction between the resident and the doctor. Generally the facility nurse is also available during the consultation.

Residents will be referred for assessment by their GP, or a clinical practice nurse.

Assessment data will be collected by the facility nurse and made available for the geriatrician for a single assessment. The assessment data is a modified version of the interRAI Long Term Care Assessment tool. It includes information about geriatric syndromes, function and cognition, medications, and activities of daily living. The facility nurse will also make available to the geriatrician the GP referral letter, any recent pathology results, and facility documentation if there is key health information applicable to the issue under consideration (ie. a behavior chart, if the resident is being assessed for BPSD).

The geriatrician will assess the resident via video conference. The geriatrician reads all the documentation provided by the GP and/or the facility nurse. The video conference then includes discussion with the resident and family (if the family is present). The geriatrician will ask questions to prompt responses that illicit additional information that is required. The geriatrician may ask the resident to walk so that gait can be observed. This consultation is very similar to what would happen if a resident went for a private consultation with a geriatrician in an out patient clinic. The duration is usually one hour, but may be more or less depending on the needs of the resident.

The resident will undertake on geriatric consultation via video conference. After that, there may be additional consulta

Primary Outcome(s)

Decrease in number of external health care visits (emergency department, hospital admissions, ambulatory clinics). The outcome will be assessed by reviewing records of admission at the facility level, and collecting State held data on admissions to acute care and emergency department episodes of care. [6 months]

Secondary Outcome(s)

Improved resident and family perception of clinical care.
For a specific period in the trial (2 months), consecutive residents will be asked to complete a short satisfaction questionnaire. During the same period, five families will be contacted by telephone, following a family member's video conference, and asked a short number of questions regarding their perception of the contribution of VC to clinical care.
During the same period, the same number of residents and family members will be contacted in the control sites and asked questions about their perception of the quality of clinical care (similar to the intervention sites but without VC questions). [6 months]

Reduction in hospital bed days utilized and hospital associated costs[6 months]

Reduction in the number of medications prescribed[6 months]

Greater access to specialist services, measured by the number of specialist consultations (telehealth and conventional)[6 months]

Improved resident quality of care scores derived from Quality Indicators[6 months]

Reduced cost of escorts and specialized transport for external consultations. All external health care visits that require a facility employed escort will have the time the staff member left the facility recorded as well as the time of the staff members return. This is standard documentation in a residential care facility. This information will be used to calculate the cost of escorting. [6 months]

Improved staff satisfaction in relation to clinical care.
Two focus groups will be held with staff. One just as the trial is commencing and one later in the trial (at the same time as the other stakeholder surveys are being completed). The questions will focus on the perception of the quality of clinical care. These focus groups will be held at both control and intervention sites, to assist in gauging the extent to which the VC consultation impacts perceptions of the quality of clinical care. [6 months

]

Secondary ID(s)

NHMRC ID APP1048098

Source(s) of Monetary Support

National Health and Medical Research Council

Secondary Sponsor(s)

Dr. Melinda Martin-Khan

Ethics review

Status: Approved
Approval date:
Contact:

The University of Queensland Human Research Ethics Committee

Status: Approved
Approval date:
Contact:

UNITING CARE QUEENSLAND HUMAN RESEARCH ETHICS COMMITTEE