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Geriatric CO-mAnagement for Cardiology patients in the Hospital (G-COACH): study protocol of a prospective before-after effectiveness-implementation study

INTRODUCTION: Although the majority of older patients admitted to a cardiology unit present with at least one geriatric syndrome, guidelines on managing heart disease often do not consider the complex needs of frail older patients. Geriatric co-management has demonstrated potential to improve functi...

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Autores principales: Deschodt, Mieke, Van Grootven, Bastiaan, Jeuris, Anthony, Devriendt, Els, Dierckx de Casterlé, Bernadette, Dubois, Christophe, Fagard, Katleen, Herregods, Marie-Christine, Hornikx, Miek, Meuris, Bart, Rex, Steffen, Tournoy, Jos, Milisen, Koen, Flamaing, Johan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6196878/
https://www.ncbi.nlm.nih.gov/pubmed/30344179
http://dx.doi.org/10.1136/bmjopen-2018-023593
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author Deschodt, Mieke
Van Grootven, Bastiaan
Jeuris, Anthony
Devriendt, Els
Dierckx de Casterlé, Bernadette
Dubois, Christophe
Fagard, Katleen
Herregods, Marie-Christine
Hornikx, Miek
Meuris, Bart
Rex, Steffen
Tournoy, Jos
Milisen, Koen
Flamaing, Johan
author_facet Deschodt, Mieke
Van Grootven, Bastiaan
Jeuris, Anthony
Devriendt, Els
Dierckx de Casterlé, Bernadette
Dubois, Christophe
Fagard, Katleen
Herregods, Marie-Christine
Hornikx, Miek
Meuris, Bart
Rex, Steffen
Tournoy, Jos
Milisen, Koen
Flamaing, Johan
author_sort Deschodt, Mieke
collection PubMed
description INTRODUCTION: Although the majority of older patients admitted to a cardiology unit present with at least one geriatric syndrome, guidelines on managing heart disease often do not consider the complex needs of frail older patients. Geriatric co-management has demonstrated potential to improve functional status, and reduce complications and length of stay, but evidence on the effectiveness in cardiology patients is lacking. This study aims to determine if geriatric co-management is superior to usual care in preventing functional decline, complications, mortality, readmission rates, reducing length of stay and improving quality of life in older patients admitted for acute heart disease or for transcatheter aortic valve implantation, and to identify determinants of success for geriatric co-management in this population. METHODS AND ANALYSIS: This prospective quasi-experimental before-and-after study will be performed on two cardiology units of the University Hospitals Leuven in Belgium in patients aged ≥75 years. In the precohort (n=227), usual care will be documented. A multitude of implementation strategies will be applied to allow for successful implementation of the model. Patients in the after cohort (n=227) will undergo a comprehensive geriatric assessment within 24 hours of admission to stratify them into one of three groups based on their baseline risk for developing functional decline: low-risk patients receive proactive consultation, high-risk patients will be co-managed by the geriatric nurse to prevent complications and patients with acute geriatric problems will receive an additional medication review and co-management by the geriatrician. ETHICS AND DISSEMINATION: The study protocol was approved by the Medical Ethics Committee UZ Leuven/KU Leuven (S58296). Written voluntary (proxy-)informed consent will be obtained from all participants at the start of the study. Dissemination of results will be through articles in scientific and professional journals both in English and Dutch and by conference presentations. TRIAL REGISTRATION NUMBER: NCT02890927.
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spelling pubmed-61968782018-10-25 Geriatric CO-mAnagement for Cardiology patients in the Hospital (G-COACH): study protocol of a prospective before-after effectiveness-implementation study Deschodt, Mieke Van Grootven, Bastiaan Jeuris, Anthony Devriendt, Els Dierckx de Casterlé, Bernadette Dubois, Christophe Fagard, Katleen Herregods, Marie-Christine Hornikx, Miek Meuris, Bart Rex, Steffen Tournoy, Jos Milisen, Koen Flamaing, Johan BMJ Open Geriatric Medicine INTRODUCTION: Although the majority of older patients admitted to a cardiology unit present with at least one geriatric syndrome, guidelines on managing heart disease often do not consider the complex needs of frail older patients. Geriatric co-management has demonstrated potential to improve functional status, and reduce complications and length of stay, but evidence on the effectiveness in cardiology patients is lacking. This study aims to determine if geriatric co-management is superior to usual care in preventing functional decline, complications, mortality, readmission rates, reducing length of stay and improving quality of life in older patients admitted for acute heart disease or for transcatheter aortic valve implantation, and to identify determinants of success for geriatric co-management in this population. METHODS AND ANALYSIS: This prospective quasi-experimental before-and-after study will be performed on two cardiology units of the University Hospitals Leuven in Belgium in patients aged ≥75 years. In the precohort (n=227), usual care will be documented. A multitude of implementation strategies will be applied to allow for successful implementation of the model. Patients in the after cohort (n=227) will undergo a comprehensive geriatric assessment within 24 hours of admission to stratify them into one of three groups based on their baseline risk for developing functional decline: low-risk patients receive proactive consultation, high-risk patients will be co-managed by the geriatric nurse to prevent complications and patients with acute geriatric problems will receive an additional medication review and co-management by the geriatrician. ETHICS AND DISSEMINATION: The study protocol was approved by the Medical Ethics Committee UZ Leuven/KU Leuven (S58296). Written voluntary (proxy-)informed consent will be obtained from all participants at the start of the study. Dissemination of results will be through articles in scientific and professional journals both in English and Dutch and by conference presentations. TRIAL REGISTRATION NUMBER: NCT02890927. BMJ Publishing Group 2018-10-21 /pmc/articles/PMC6196878/ /pubmed/30344179 http://dx.doi.org/10.1136/bmjopen-2018-023593 Text en © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Geriatric Medicine
Deschodt, Mieke
Van Grootven, Bastiaan
Jeuris, Anthony
Devriendt, Els
Dierckx de Casterlé, Bernadette
Dubois, Christophe
Fagard, Katleen
Herregods, Marie-Christine
Hornikx, Miek
Meuris, Bart
Rex, Steffen
Tournoy, Jos
Milisen, Koen
Flamaing, Johan
Geriatric CO-mAnagement for Cardiology patients in the Hospital (G-COACH): study protocol of a prospective before-after effectiveness-implementation study
title Geriatric CO-mAnagement for Cardiology patients in the Hospital (G-COACH): study protocol of a prospective before-after effectiveness-implementation study
title_full Geriatric CO-mAnagement for Cardiology patients in the Hospital (G-COACH): study protocol of a prospective before-after effectiveness-implementation study
title_fullStr Geriatric CO-mAnagement for Cardiology patients in the Hospital (G-COACH): study protocol of a prospective before-after effectiveness-implementation study
title_full_unstemmed Geriatric CO-mAnagement for Cardiology patients in the Hospital (G-COACH): study protocol of a prospective before-after effectiveness-implementation study
title_short Geriatric CO-mAnagement for Cardiology patients in the Hospital (G-COACH): study protocol of a prospective before-after effectiveness-implementation study
title_sort geriatric co-management for cardiology patients in the hospital (g-coach): study protocol of a prospective before-after effectiveness-implementation study
topic Geriatric Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6196878/
https://www.ncbi.nlm.nih.gov/pubmed/30344179
http://dx.doi.org/10.1136/bmjopen-2018-023593
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