LANTERN: Evaluating the Unmet Needs of Older Adults to Promote Functional Recovery After a Critical Illness
Study Details
Study Description
Brief Summary
This is a prospective longitudinal study that will evaluate the unmet needs of older adults (65 and older) who return home (either directly or after short-term rehab) after an ICU hospitalization, evaluate the association of these unmet needs with clinically relevant outcomes, and assess barriers and facilitators to addressing these unmet needs. The proposed research will inform the development and evaluation of a subsequent intervention to improve functional outcomes among older ICU survivors, in alignment with the NIH's mission to reduce disability.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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Detailed Description
To identify unmet needs in multiple domains after return home from an ICU hospitalization, evaluate whether these unmet needs are associated with disability burden in the subsequent 6 months, and ascertain whether these associations are moderated by initial discharge destination (home or STR).
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Older adults returning home post-ICU Community-dwelling older adults who return home (either directly or after a stay in short-term rehab (STR)) after an ICU hospitalization. |
Outcome Measures
Primary Outcome Measures
- Disability Count [monthly up to 6 months]
Number of instances of disability during activities of daily living (ADLs), instrumental activities of daily living (IADLs), and mobility activity. Disability is defined as an inability to complete the task or the need for personal assistance to complete the task. The higher the count, the more disability.
- Number of hospital readmissions [monthly up to 6 months]
Number of hospital readmissions monthly up to 6 months.
- Number of deaths [monthly up to 6 months]
Number of deaths each month up to 6 months.
- Barriers and Facilitators to addressing unmet needs [month 6]
Barriers and facilitators to addressing unmet needs will be assessed using qualitative interviews. A subgroup of participants will receive qualitative interviews conducted with members of the study team. Content analysis will then be used to identify barriers and facilitators to addressing unmet needs that will be informative when planning a future intervention.
Secondary Outcome Measures
- Functional non-recovery [monthly up to 6 months]
Not returning to the pre-ICU functional baseline within the follow-up period
Eligibility Criteria
Criteria
Inclusion Criteria:
PARTICIPANTS
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Age ≥ 65 years
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Survived an ICU admission of ≥2 days
CAREGIVERS
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Age ≥ 18 years
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Identified as caregiver of LANTERN participant who is an informal (unpaid) caregiver.
Exclusion Criteria:
PARTICIPANTS
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Advance directive of comfort measures only (CMO) or a transition to hospice
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Planned discharge to a location other than home or Short-Term Rehab
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Tracheostomy with ventilator dependence
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Severe acute or prior neurologic injury (such as anoxic brain injury or acute, massive stroke)
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Advanced dementia
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ICU admission for monitoring only (e.g., antibiotic desensitization)
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Primary language other than English.
CAREGIVERS
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Primary language other than English
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Is a paid caregiver
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Unwilling to complete a qualitative interview
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Yale New Haven Hospital | New Haven | Connecticut | United States | 06520 |
Sponsors and Collaborators
- Yale University
- National Institute on Aging (NIA)
Investigators
- Principal Investigator: Lauren Ferrante, MD, MHS, Yale School of Medicine
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 2000034943
- 1R01AG079916-01A1