GRACE: Geriatric Resources for Assessment and Care of Elders

Sponsor

National Institute on Aging (NIA) (NIH)

Overall Status

Completed

CT.gov ID

NCT00182962

Collaborator

Nina Mason Pulliam Charitable Trust (Other), Wishard Health Services (Other)

1,270

Enrollment

Location

Duration (Months)

23.1

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

The purpose of this study is to test the effectiveness of a collaborative model of team care as compared to usual care in improving functional outcomes among community-dwelling low-income older adults.

Condition or Disease	Intervention/Treatment	Phase
Functional Decline Aging	Behavioral: Geriatric Resources for Assessment & Care of Elders (GRACE)	N/A

Detailed Description

This collaborative model of care, Geriatric Resources for Assessment and Care of Elders (GRACE), involves a geriatric nurse practitioner and a geriatric social worker caring for the vulnerable older adult in collaboration with the patient's primary care physician to improve coordination and quality of care. The specific components of GRACE mirror those recommended in recent reviews: a) specific targeting of elders at risk; b) availability of collaborative expertise in geriatrics; c) integration of the program into primary care; d) coordination of care across all sites of care; e) integration of data systems that support physician's practice and facilitate monitoring of pertinent clinical parameters; and f) institutionally endorsed clinical practice guidelines. To our knowledge, there are no prior studies investigating the effectiveness of such a comprehensive approach among vulnerable older adults.

We are hypothesizing that, compared to usual care, patients enrolled in the intervention will have:

greater independence in activities of daily living over 2 years of follow-up;
better health status scores as assessed by the HEDIS® 2000 Health Outcomes Survey
fewer nursing home days over 2 years of follow-up; and
fewer hospitalizations over the 2 years of follow-up.

Study Design

Study Type:

Interventional

Allocation:

Randomized

Intervention Model:

Single Group Assignment

Masking:

Single

Primary Purpose:

Treatment

Official Title:

Geriatric Resources for Assessment and Care of Elders

Study Start Date :

Mar 1, 2002

Study Completion Date :

Oct 1, 2006

Outcome Measures

Primary Outcome Measures

Functional status []
health status []
hospitalization and nursing home placement []

Secondary Outcome Measures

Patient satisfaction and quality of care []

Eligibility Criteria

Criteria

Ages Eligible for Study:

65 Years and Older

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Yes

Inclusion Criteria:

65 years old or older
Annual income less than 200% of the federal poverty level
Have had one or more primary care visits in the past 12 months
Reside in the community (non-institutionalized)

Exclusion Criteria:

Non-English speaking
No regular access to a telephone
Currently undergoing kidney dialysis treatments
Residing with a patient already participating in the GRACE clinical trial

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Indiana University School of Medicine	Indianapolis	Indiana	United States	46202

Sponsors and Collaborators

National Institute on Aging (NIA)
Nina Mason Pulliam Charitable Trust
Wishard Health Services

Investigators

Principal Investigator: Steven R. Counsell, MD, Indiana University Geriatrics Program, Indiana University Center for Aging Research, Indiana University School of Medicine