Nursing Home Prevention of Injury in Dementia (NH PRIDE)
Accidental Falls/Prevention and Control
Bottom Line
View on ClinicalTrials.gov: NCT04242186 ↗Study Design & Population
- Study type
- Interventional
- Phase
- N/A
- Interventions
- Injury Liaison Service (Other)
- Age
- Adult, Older Adult · 60+ yrs
- Sex
- All
- Sponsor
- Hebrew SeniorLife
- Primary completion
- May 2022
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Number of High-risk Residents According to the FRAiL Model |
46 | — |
| PRIMARY Number of High-risk Residents With One or More Deprescribing Recommendations |
36 | — |
| PRIMARY Number of Residents Whose Provider Accepted One or More Deprescribing Recommendations |
21 | — |
| PRIMARY Number of Residents Who Accepted One or More Deprescribing Recommendations |
21 | — |
| PRIMARY Number of High-risk Residents With a Recommendation for Osteoporosis Treatment |
20 | — |
| PRIMARY Number of Residents Whose Provider Accepted Osteoporosis Treatment Recommendations |
10 | — |
| PRIMARY Number of Residents Who Accepted Osteoporosis Treatment Recommendations |
10 | — |
| PRIMARY Attrition of Eligible Residents From the NH Facility Due to Transfer, Discharge to Community, or Death |
6 | — |
| PRIMARY Proportion of Staff Members Who Indicated They Were Satisfied or Very Satisfied With the ILS on a Post-intervention Survey |
17 | — |
| PRIMARY Number of Staff Members Who Attended One or More ECHO Sessions |
21 | — |
| SECONDARY Average Number of Deprescribing Recommendations That Were Made for Each Resident |
2.2 | — |
| SECONDARY Average Number of Adverse Drug Events |
0.05 | — |
| SECONDARY Number of Injurious Falls |
0.07 | — |
Summary
Eligibility Criteria
Inclusion Criteria
Facility inclusion criteria:
- More than 80 long-stay beds
- Within 30 miles of Boston, Massachusetts or Durham, North Carolina
Resident inclusion criteria:
- Age ≥ 60 years
- NH length of stay ≥ 30 days
- Estimated 2-year risk of hip fracture ≥ 6% using FRAiL model
Provider inclusion criteria:
The NH-PRIDE intervention will target the "usual" providers including nurses, certified nursing assistants (CNAs), physicians, nurse practitioners (NPs), and physician assistants (PAs) routinely caring for NH patients. Nurses should be providing care at a NH facility for a minimum of 2 shifts most weeks. Physicians, NPs, and PAs should spend, on average a minimum of four hours weekly in nursing home care. We estimate there will be 10 providers for the qualitative interviews on injurious falls prevention, 20 providers (4 from each facility) in the televideo sessions, and 60 providers (15 per facility) to participate in the post-intervention questionnaires.
Additional eligibility criteria for providers include:
- Worked in the facility for ≥ 90 days
- Can communicate in English (in order to participate in interviews and questionnaires),
- Over 21 years of age.
Proxy/resident inclusion criteria:
We will recruit 10 residents/proxies to participate in qualitative interviews on falls prevention. Residents/family must meet the following criteria:
- Affiliated resident has lived in the facility for ≥ 30 days
- Can communicate in English
- Over 21 years of age
- Able to provide informed consent to participate in the interviews
Exclusion Criteria
Facility exclusion criteria:
- Population not primarily English speaking
- Evidence of institutional instability at time of recruitment
Provider exclusion criteria:
- Does not provide routine care to NH residents (e.g., visiting hospice provider)
- Does not speak English
- Is less than 21 years old
Resident exclusion criteria:
- Advanced dementia as defined by Cognitive Performance Scale (CPS) = 6
- Life expectancy < 6 months, as indicated by Minimum Data Set (MDS) assessment
- Living in nursing home for less than 30 days
- Proxy has communicated wish to opt-out of study Residents will not be excluded from the study based on any specific diagnosis (e.g., congestive heart failure or schizophrenia); however, the algorithm used to make recommendations for medication management will consider individual co-morbidities.
Proxy/resident exclusion criteria for interviews:
- Affiliated resident has lived in the facility for < 30 days
- Cannot communicate in English
- Less than 21 years of age
- Unable to provide informed consent to participate
Data sourced from ClinicalTrials.gov (NCT04242186). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.