The Clinical Evaluation of Continuous Assistance Offered to Older People Living Independently. (HOMESWEETHOME)

• Quality of life (QoL) [ Time Frame: measurement will be at trial start (t=0 months) ] [ Designated as safety issue: No ]
  Health related QoL as measured with Health Status Questionnaire Short Form 36 (SF-36) (v2).
  
  
• Quality of life (QoL) [ Time Frame: measurement will be at trial midterm (t=15 months) ] [ Designated as safety issue: No ]
  Health related QoL as measured with Health Status Questionnaire Short Form 36 (SF-36) (v2).
  
  
• Quality of life (QoL) [ Time Frame: measurement will be at trial end (t=30 months) ] [ Designated as safety issue: No ]
  Health related QoL as measured with Health Status Questionnaire Short Form 36 (SF-36) (v2).
  
  

• Nursing home admission [ Time Frame: measurement will be at trial start (t=0months) ] [ Designated as safety issue: No ]
  Nursing home admission as assessed from records/equivalent sources
  
  
• Mortality [ Time Frame: continous monitoring during trial duration = 30 months. ] [ Designated as safety issue: No ]
  deceasing of participant
  
  
• Frailty [ Time Frame: measurement will be at trial start (t=0 months) ] [ Designated as safety issue: No ]
  Frailty as asessed with Edmonton Frailty Scale (EFS)
  
  
• Geriatric assessment [ Time Frame: measurement will be at trial start (t=0 months) ] [ Designated as safety issue: No ]
  as assesses with Comprehensive Geriatric Assessment (CGA)
  
  
• Clinical Global Impression [ Time Frame: measurement will be at trial start (t=0 months) ] [ Designated as safety issue: No ]
  as assessed with Clinical Global Impression (CGI)
  
  
• Depression and anxiety [ Time Frame: measurement will be at trial start (t=0 months) ] [ Designated as safety issue: No ]
  as assessed with Hospital Anxiety and Depression Scale (HADS).
  
  
• Nursing home admission [ Time Frame: measurement will be at trial midterm (t=15 months) ] [ Designated as safety issue: No ]
  Nursing home admission as assessed from records/equivalent sources
  
  
• Nursing home admission [ Time Frame: measurement will be at trial end (t=30 months). ] [ Designated as safety issue: No ]
  Nursing home admission as assessed from records/equivalent sources
  
  
• Frailty [ Time Frame: measurement will be at trial midterm (t=15 months) ] [ Designated as safety issue: No ]
  Frailty as asessed with Edmonton Frailty Scale (EFS)
  
  
• Frailty [ Time Frame: measurement will be at trial end (t=30 months) ] [ Designated as safety issue: No ]
  Frailty as asessed with Edmonton Frailty Scale (EFS)
  
  
• Geriatric assessment [ Time Frame: measurement will be at trial midterm (t=15 months) ] [ Designated as safety issue: No ]
  as assesses with Comprehensive Geriatric Assessment (CGA)
  
  
• Geriatric assessment [ Time Frame: measurement will be at trial end (t=30 months) ] [ Designated as safety issue: No ]
  as assesses with Comprehensive Geriatric Assessment (CGA)
  
  
• Depression and anxiety [ Time Frame: measurement will be at trial midterm (t=15 months) ] [ Designated as safety issue: No ]
  as assessed with Hospital Anxiety and Depression Scale (HADS).
  
  
• Depression and anxiety [ Time Frame: measurement will be at trial end (t=30 months) ] [ Designated as safety issue: No ]
  as assessed with Hospital Anxiety and Depression Scale (HADS).
  
  
• Clinical Global Impression [ Time Frame: measurement will be at trial midterm (t=15 months) ] [ Designated as safety issue: No ]
  as assessed with Clinical Global Impression (CGI)
  
  
• Clinical Global Impression [ Time Frame: measurement will be at trial end (t=30 months) ] [ Designated as safety issue: No ]
  as assessed with Clinical Global Impression (CGI)
  
  
• Number of hospitalisations [ Time Frame: measurement will be at trial start (t=0 months) ] [ Designated as safety issue: No ]
  
• Number of hospitalizations [ Time Frame: measurement will be at trial midterm (t=15 months). ] [ Designated as safety issue: No ]
  
• Number of hospitalisations [ Time Frame: measurement will be at trial end (t=30 months) ] [ Designated as safety issue: No ]
  
• Number of accesses to emergency rooms [ Time Frame: measurement will be at trial start (t=0 months) ] [ Designated as safety issue: No ]
  
• Number of accesses to emergency rooms [ Time Frame: measurement will be at trial midterm (t=15 months). ] [ Designated as safety issue: No ]
  
• Number of accesses to emergency rooms [ Time Frame: measurement will be at trial end (t=30 months) ] [ Designated as safety issue: No ]
  

The HOMESWEETHOME clinical trial is conducted as a multi-centre randomised control trial (RCT), across four pilot sites. The trial design, analysis and reporting follow the "Revised CONSORT - Consolidated Standards of Reporting Trials - Statement" and subsequent additions to the CONSORT statement.

HOMESWEETHOME services are expected to result in an outcome that is superior to usual care alone in reducing deterioration of health related quality of life and function associated with age and chronic disease. This effect will be measured by assessing different outcomes.

The clinical evaluation of the HOMESWEETHOME project sets out to assess the long-term effects of continuous assistance offered by the HOMESWEETHOME services to older people living independently. The trial will test the hypothesis that while providing a level of safety equivalent to or better than that enjoyed in older people‟s homes, there is a significant positive effect on the quality of life (QoL) and the duration of independently living of older people.

The study is conducted in four sites within the European Union, these sites will have the number of participants randomised into Intervention Group and Control Group, as follows:

• Belgium - City of Antwerp 30 + 30
• Catalonia - Town of Badalona 15 + 15
• Ireland - North Eastern Region 30 + 30
• Italy - Town of Latina 30 + 30 The main inclusion criteria for participants‟ entry into the trial will be based on frailty. Frailty is a concept associated with adverse outcomes such as higher morbidity, more hospitalisations and falls, and a lower quality of life. Furthermore, frailty predicts - better than age - the evolution to disability and death. Participants must also be 65 years or over, and living at home. The main reasons for excluding participants will be based on their physical or mental (in)ability to take part.

The primary clinical outcome for the trials will be measured based on the Health Status Questionnaire Short Form 36 (SF-36) (v2).

Secondary outcomes will be measured using Edmonton Frailty Scale (EFS), Comprehensive Geriatric Assessment (CGA), Clinical Global Impression (CGI), and Hospital Anxiety and Depression Scale (HADS). A number of medical events will also be measured.

Measurements will be taken at trial start, trial mid-term, and trial end. Measurements will be entered, anonymously, into a database for analysis of results. The trial population size has been subjected to a statistical power analysis, to ensure statistical significance of project results.