Can a Rapid 2 Day Followup After Discharge From the ED Reduce Readmissions and Death for Patients 75 Years and Older?
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Purpose
Our hypothesis is that a rapid follow up for elderly patients in a Geriatric Clinic discharged from the Emergency Department (ED) will have fewer unplanned return ED visits and fewer unplanned hospital admissions with no attendant increase in mortality.
Patients 75 years of age and older will be randomized following discharge from the ED into two groups. The first will receive standard post ED care. The second will receive an appointment to our Geriatric Clinic within 2-3 days for stabilization, further treatment and contact with the patient's primary physician to communicate the course of the patient's illness and to schedule subsequent follow-up with the patients regular medical provider.
There will be two primary outcomes: The first will be a composite of morality and/or return to the ED at 30 days, and the secondary primary outcome will be mortality. Economic data regarding resource utilization by patients will also be analyzed.
| Condition | Intervention |
|---|---|
|
Patients 75 Years of Age and Older. |
Other: 2-3 day return appointment |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Prevention |
| Official Title: | A Randomized Trial of the Effect of a Geriatrics Appointment Within 2-3 Days of Discharge From the Emergency Department(ED) in Reducing ED and Hospital Readmissions for Patients 75 Years of Age and Older. |
- Mortality and readmissions to emergency department [ Time Frame: 30 and 180 days ] [ Designated as safety issue: No ]
- Mortality [ Time Frame: 30 and 180 days ] [ Designated as safety issue: No ]Secondary outcome to measure all cause mortality for patients admitted to the study.
- Medical Resource utilization [ Time Frame: 30 days and 180 days ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 2200 |
| Study Start Date: | June 2013 |
| Estimated Study Completion Date: | June 2016 |
| Estimated Primary Completion Date: | June 2015 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
No Intervention: Control
Standard post ED care
|
|
|
Experimental: 2-3 day return appointment
Patients will receive further treatment in Geriatric Clinic 2-3 days post ED discharge.
|
Other: 2-3 day return appointment
2-3 appointment in geriatric clinic following ED discharge
|
Eligibility| Ages Eligible for Study: | 75 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- All patients 75 years of age and older discharged from the ED
Exclusion Criteria:
- Younger than 75.
Contacts and Locations| Contact: John S Kizer, MD | (919)966-1456 | jskizer@med.unc.edu |
| Contact: Kevin Biese, MD | (919) 966-8926 | kbiese@med.unc.edu |
| United States, North Carolina | |
| University of North Carolina | |
| Chapel Hill, North Carolina, United States, 27599-7550 | |
| Principal Investigator: | John S Kizer, MD | UNC Chapel Hill, NC |
More Information
No publications provided
| Responsible Party: | John S Kizer, MD, Professor of Medicine, Geriatrics and Pharmacology, University of North Carolina, Chapel Hill |
| ClinicalTrials.gov Identifier: | NCT01769495 History of Changes |
| Other Study ID Numbers: | DE 6366-SP |
| Study First Received: | January 14, 2013 |
| Last Updated: | April 2, 2013 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by University of North Carolina, Chapel Hill:
|
Emergency department, Geriatrics, mortality, readmission rates. |
ClinicalTrials.gov processed this record on May 23, 2013