RCT of Comprehensive Geriatric Assessment in a HAH setting v 1.0
Research type
Research Study
Full title
A Multi-Centre Randomised Controlled Trial to Compare the Effectiveness of Admission Avoidance Hospital at Home with Comprehensive Geriatric Assessment vs. Inpatient Comprehensive Geriatric Assessment on the Number of Frail Older People ‘Living at Home’
IRAS ID
156916
Contact name
Sasha Shepperd
Contact email
Sponsor organisation
Oxford Radcliffe Hospitals NHS Trust
Research summary
Evidence is needed on how to provide acute hospital level care to older adults in greater numbers with a fixed or shrinking hospital resource. Without this perspective existing models of acute hospital care will become unworkable as the health service deals with an increased number of frail older people with complex health needs who are being admitted to hospital as an emergency. In addition, concern that the acute hospital setting is generally not the best place for the care of frail older people means there is an urgent need to evaluate alternative systems of healthcare that avoid hospital admission. Evidence suggests that admission avoidance hospital at home (HAH), that provides specialist led multi-level assessment and a tailored management plan delivered by a multi-disciplinary team (otherwise known as Comprehensive Geriatric Assessment (CGA)) in a home setting, may be effective for older people with frailty. However, the evidence is limited to a few small randomised controlled trials (RCTs). We aim to evaluate whether admission avoidance HaH with CGA gives benefits to older people with frailty, and if it is a cost-effective way of providing healthcare. Patients referred to a HAH service will be invited to take part in the study, at which point they will be randomised in a 2:1 ratio to HAH with CGA or inpatient care. The follow up for each patient will last for a year with the primary outcome being whether or not the patient is living at home at the end of follow-up, we will also assess the cost-effectiveness of HAH compared with hospital care. We plan to recruit a total of 1,552 participants from England, Wales and Scotland.
REC name
Wales REC 4
REC reference
14/WA/1081
Date of REC Opinion
20 Aug 2014
REC opinion
Further Information Favourable Opinion