Home-based Nurse Intervention in the Care of High Risk of Death Patients After Discharge From Ger… (NCT06481917) | Clinical Trial Compass
Not Yet RecruitingNot Applicable
Home-based Nurse Intervention in the Care of High Risk of Death Patients After Discharge From Geriatric Department
France104 participantsStarted 2024-10
Plain-language summary
This study consists to evaluate the feasibility of a case-management intervention of Advance Care Plan (ACP) placement for elderly patients at high risk of death at twelve months discharged alive from acute geriatric medicine.
Feasibility will include the following indicators: rate of patients included and randomized, rate of patients remaining in the study, ACP rates achieved at one month.
Who can participate
Age range
75 Years
Sex
ALL
See this in plain English?
AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.
Inclusion Criteria:
* Patients aged 75 or over.
* Affiliated to a social security scheme.
* Hospitalized in an acute care geriatric department
* Discharged from hospital to home or residential facilities for dependent elderly people
* Targeted pathology or at least one incurable disease.
* At high risk of death in the twelve months following discharge according to the DAMAGE prognostic score (high-risk score group). A high risk of death is defined by a DAMAGE score \> 50%.
* Rockwood Clinical frailty scale score greater than or equal to 7 at one month.
Exclusion Criteria:
* Refusal to participate in the study expressed by the patient or his/her legal representative, if applicable.
* Patients transferred to another Medicine-Surgery-Obstetrics department (only "medicine or surgery" in the elderly).
* Patients transferred to follow-up care and rehabilitation, palliative care, or returning home in palliative care.
* Patients who have already drawn up advance directives, chosen a trusted support person or discussed their end-of-life wishes with their doctor.
* Patients with proven severe neuro-cognitive disorders (in the medical record with a Mini-Mental State Examination (MMSE) score below 10 or in the absence of knowledge of the degree of severity and/or a recent previous MMSE score taken in a stable period, the referring practitioner, a geriatrician with expertise in this field, will assess whether the patient is unfit to state his or her advance directives at the time of in…
Questions worth asking your doctor
Bring these to your next appointment. They're a starting point for a shared conversation — not a sign you qualify or a recommendation to enrol.
1Based on my diagnosis and history, is this trial worth exploring for me — or is there a standard treatment we should try first?
2What does this trial's phase tell us about how much is already known about its safety and benefit?
3What would taking part actually involve for me — visits, tests, time, and travel?
4What are the known and possible risks or side effects I should weigh, and how would they be monitored?
5If this trial isn't the right fit, what other options or trials would you suggest I look into?
Generated to help you prepare — always confirm anything about your own eligibility and care with the study team and your doctor.
Questions for the trial coordinator
The trial coordinator is the person who runs the study day to day. These cover the practical side — logistics, costs, and what taking part would actually mean for your life. The study team confirms whether you meet the criteria; these are questions to ask, not a sign you qualify.
1What does taking part actually involve week to week — how many visits, where, and how long does each one take?
2What costs are covered by the study, and what might I have to pay for myself, including travel, parking, or time off work?
3What happens during screening, and what happens if the study team confirms I don't meet the criteria after those tests?
4Who pays for the scans, blood work, and other tests the trial requires — the study, my insurance, or me?
5How will being in the trial affect my regular care, and will my own doctor stay informed and involved?
6Can I leave the trial at any point if I change my mind, and what would happen to my care if I do?
A starting point for the conversation — always confirm anything about your own eligibility, costs, and care with the study team and your doctor.