Cargando…
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...
Autores principales: | , , , , , , , , , , , , , |
---|---|
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 |
_version_ | 1783364642284765184 |
---|---|
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. |
format | Online Article Text |
id | pubmed-6196878 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT deschodtmieke geriatriccomanagementforcardiologypatientsinthehospitalgcoachstudyprotocolofaprospectivebeforeaftereffectivenessimplementationstudy AT vangrootvenbastiaan geriatriccomanagementforcardiologypatientsinthehospitalgcoachstudyprotocolofaprospectivebeforeaftereffectivenessimplementationstudy AT jeurisanthony geriatriccomanagementforcardiologypatientsinthehospitalgcoachstudyprotocolofaprospectivebeforeaftereffectivenessimplementationstudy AT devriendtels geriatriccomanagementforcardiologypatientsinthehospitalgcoachstudyprotocolofaprospectivebeforeaftereffectivenessimplementationstudy AT dierckxdecasterlebernadette geriatriccomanagementforcardiologypatientsinthehospitalgcoachstudyprotocolofaprospectivebeforeaftereffectivenessimplementationstudy AT duboischristophe geriatriccomanagementforcardiologypatientsinthehospitalgcoachstudyprotocolofaprospectivebeforeaftereffectivenessimplementationstudy AT fagardkatleen geriatriccomanagementforcardiologypatientsinthehospitalgcoachstudyprotocolofaprospectivebeforeaftereffectivenessimplementationstudy AT herregodsmariechristine geriatriccomanagementforcardiologypatientsinthehospitalgcoachstudyprotocolofaprospectivebeforeaftereffectivenessimplementationstudy AT hornikxmiek geriatriccomanagementforcardiologypatientsinthehospitalgcoachstudyprotocolofaprospectivebeforeaftereffectivenessimplementationstudy AT meurisbart geriatriccomanagementforcardiologypatientsinthehospitalgcoachstudyprotocolofaprospectivebeforeaftereffectivenessimplementationstudy AT rexsteffen geriatriccomanagementforcardiologypatientsinthehospitalgcoachstudyprotocolofaprospectivebeforeaftereffectivenessimplementationstudy AT tournoyjos geriatriccomanagementforcardiologypatientsinthehospitalgcoachstudyprotocolofaprospectivebeforeaftereffectivenessimplementationstudy AT milisenkoen geriatriccomanagementforcardiologypatientsinthehospitalgcoachstudyprotocolofaprospectivebeforeaftereffectivenessimplementationstudy AT flamaingjohan geriatriccomanagementforcardiologypatientsinthehospitalgcoachstudyprotocolofaprospectivebeforeaftereffectivenessimplementationstudy |