Evaluation of a technology-enhanced integrated care model for frail older persons: protocol of the SPEC study, a stepped-wedge cluster randomized trial in nursing homes

BMC Geriatrics

Study Protocol

Myunghee Cho Paik¹  Gi-Soo Kim¹  Yeon-Hwan Park²  Hongsoo Kim³  Tae-Jin Lee⁴  Dong-wook Yang⁵  Seyune Lee⁵  Young-il Jung⁶  Hyoungshim Choi⁷ 

[1] College of Natural Sciences, Department of Statistics, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, South Korea;College of Nursing, the Research Institute of Nursing Science, Seoul National University, Daehakro 103, Jongno-Gu, Seoul, South Korea;Department of Public Health Science at Graduate School of Public Health, Institute of Aging, Institute of Health and Environment, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, South Korea;Department of Public Health Science at Graduate School of Public Health, Institute of Health and Environment, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, South Korea;Department of Public Health Science at Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, South Korea;Institute of Health and Environment, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, South Korea;Youngsan University, College of Nursing, Yangsan Campus, 288 Junam-ro, 50510, Yangsan, Gyeongnam, South Korea;

关键词: Chronic care model;    Geriatric care model;    Long-term care;    Technology;    Stepped-wedge trials;    Quality of care;    Quality of life;    Economics;    Elderly;    Process evaluation;   

DOI  :  10.1186/s12877-017-0459-7

 received in 2016-12-17, accepted in 2017-03-07,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundLimited evidence exists on the effectiveness of the chronic care model for people with multimorbidity. This study aims to evaluate the effectiveness of an information and communication technology- (ICT-)enhanced integrated care model, called Systems for Person-centered Elder Care (SPEC), for frail older adults at nursing homes.Methods/DesignSPEC is a prospective stepped-wedge cluster randomized trial conducted at 10 nursing homes in South Korea. Residents aged 65 or older meeting the inclusion/exclusion criteria in all the homes are eligible to participate. The multifaceted SPEC intervention, a geriatric care model guided by the chronic care model, consists of five components: comprehensive geriatric assessment for need/risk profiling, individual need-based care planning, interdisciplinary case conferences, person-centered care coordination, and a cloud-based information and communications technology (ICT) tool supporting the intervention process. The primary outcome is quality of care for older residents using a composite measure of quality indicators from the interRAI LTCF assessment system. Outcome assessors and data analysts will be blinded to group assignment. Secondary outcomes include quality of life, healthcare utilization, and cost. Process evaluation will be also conducted.DiscussionThis study is expected to provide important new evidence on the effectiveness, cost-effectiveness, and implementation process of an ICT-supported chronic care model for older persons with multiple chronic illnesses. The SPEC intervention is also unique as the first registered trial implementing an integrated care model using technology to promote person-centered care for frail older nursing home residents in South Korea, where formal LTC was recently introduced.Trial registration10.1186/ISRCTN11972147

【 授权许可】

CC BY   
© The Author(s). 2017