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      COMPrehensive geriatric AsseSSment and multidisciplinary team intervention for hospitalised older adults (COMPASS): a protocol of pragmatic trials within a cohort

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          Abstract

          Introduction

          There is an increased demand for services for hospitalised older patients with acute medical conditions due to rapidly ageing population. The COMPrehensive geriatric AsseSSment and multidisciplinary team intervention for hospitalised older adults (COMPASS) study will test the effectiveness of comprehensive geriatric assessment (CGA) and multidisciplinary intervention by comparing it with conventional care among acute hospitalised older adults in Korea.

          Methods and analysis

          A multicentre trial within a cohort comprising three substudies (randomised controlled trials) will be conducted. The intervention includes CGA and CGA-based multidisciplinary interventions by physicians (geriatricians, oncologists), nurses, nutritionists and pharmacists. The multidisciplinary intervention includes nutritional support, medication review and adjustment, rehabilitation, early discharge planning and prevention of geriatric syndromes (falls, delirium, pressure sore and urinary retention). The analysis will be based on an intention-to-treat principle. The primary outcome is living at home 3 months after discharge. In addition to assessing the economic effects of the intervention, a cost-utility analysis will be conducted.

          Ethics and dissemination

          The study protocol was reviewed and approved by the ethics committees of Seoul National University Bundang Hospital and each study site. The study findings will be published in peer-reviewed journals. Subgroup and further in-depth analyses will subsequently be published.

          Trial registration number

          KCT0006270.

          Related collections

          Most cited references24

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          A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation

          Mary Charlson, Peter Pompei, Kathy Ales … (1987)
          The objective of this study was to develop a prospectively applicable method for classifying comorbid conditions which might alter the risk of mortality for use in longitudinal studies. A weighted index that takes into account the number and the seriousness of comorbid disease was developed in a cohort of 559 medical patients. The 1-yr mortality rates for the different scores were: "0", 12% (181); "1-2", 26% (225); "3-4", 52% (71); and "greater than or equal to 5", 85% (82). The index was tested for its ability to predict risk of death from comorbid disease in the second cohort of 685 patients during a 10-yr follow-up. The percent of patients who died of comorbid disease for the different scores were: "0", 8% (588); "1", 25% (54); "2", 48% (25); "greater than or equal to 3", 59% (18). With each increased level of the comorbidity index, there were stepwise increases in the cumulative mortality attributable to comorbid disease (log rank chi 2 = 165; p less than 0.0001). In this longer follow-up, age was also a predictor of mortality (p less than 0.001). The new index performed similarly to a previous system devised by Kaplan and Feinstein. The method of classifying comorbidity provides a simple, readily applicable and valid method of estimating risk of death from comorbid disease for use in longitudinal studies. Further work in larger populations is still required to refine the approach because the number of patients with any given condition in this study was relatively small.
          Article 0 comments Cited 6050 times – based on 0 reviews     Review now
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            Assessment of Older People: Self-Maintaining and Instrumental Activities of Daily Living

            M P Lawton, E M Brody (1969)
            Article 0 comments Cited 1874 times – based on 0 reviews     Review now
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              CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials

              Kenneth F Schulz, Douglas G. Altman, David Moher … (2010)
              The CONSORT statement is used worldwide to improve the reporting of randomised controlled trials. Kenneth Schulz and colleagues describe the latest version, CONSORT 2010, which updates the reporting guideline based on new methodological evidence and accumulating experience
              Article 0 comments Cited 1668 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): BMJ Open
                Journal ID (iso-abbrev): BMJ Open
                Journal ID (hwp): bmjopen
                Journal ID (publisher-id): bmjopen
                Title: BMJ Open
                Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                ISSN (Electronic): 2044-6055
                Publication date Collection: 2022
                Publication date (Electronic): 1 August 2022
                Volume: 12
                Issue: 8
                Electronic Location Identifier: e060913
                Affiliations
                [1 ]departmentInternal Medicine , Seoul National University Bundang Hospital , Seongnam, Korea
                [2 ]Yonsei University College of Nursing , Seoul, Korea
                [3 ]departmentPreventive Medicine and Institute of Health Service Research , Yonsei University College of Medicine , Seodaemun-gu, Seoul, Korea
                [4 ]departmentInternal Medicine , Yonsei University College of Medicine , Seodaemun-gu, Korea
                [5 ]departmentInternal Medicine , Chung-Ang University College of Medicine , Dongjak-gu, Seoul, Korea
                [6 ]departmentInternal Medicine , Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine , Seoul, Korea
                [7 ]departmentHematology and Oncology , Ulsan University Hospital, Ulsan University College of Medicine , Ulsan, Korea
                [8 ]departmentInternal Medicine , National Health Insurance Service, Ilsan Hospital , Goyang, Korea
                [9 ]departmentInternal Medicine , Kangwon National University Hospital , Chuncheon, Kangwon, Korea
                [10 ]departmentInternal Medicine , Chonnam National University Bitgoeul Hospital , Gwang-ju, Korea
                [11 ]departmentInternal Medicine , Seoul National University College of Medicine , Seoul, Korea
                Author notes
                [Correspondence to ] Kwang-il Kim; kikim907@ 123456snu.ac.kr
                Author information
                http://orcid.org/0000-0001-5139-5346
                http://orcid.org/0000-0003-1159-6068
                http://orcid.org/0000-0002-0773-5443
                http://orcid.org/0000-0002-5554-8255
                http://orcid.org/0000-0002-7461-0333
                http://orcid.org/0000-0002-2156-5081
                http://orcid.org/0000-0002-1545-8036
                http://orcid.org/0000-0002-1334-326X
                http://orcid.org/0000-0001-6840-4931
                http://orcid.org/0000-0002-1357-7015
                http://orcid.org/0000-0002-6658-047X
                Article
                Publisher ID: bmjopen-2022-060913
                DOI: 10.1136/bmjopen-2022-060913
                PMC ID: 9345040
                PubMed ID: 35914913
                SO-VID: e10c8a2e-83ae-4cc3-b765-ca41e4d8885b
                Copyright © © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
                License:

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/.

                History
                Date received : 07 January 2022
                Date accepted : 17 July 2022
                Funding
                Funded by: Patient-Centered Clinical Research Coordinating Center (PACEN) funded by the Ministry of Health & Welfare, Republic of Korea;
                Award ID: HC20C0086
                Categories
                Subject: Geriatric Medicine
                Subject: 1506
                Subject: 1698
                Series title: Protocol
                Custom metadata
                special-feature unlocked

                ScienceOpen disciplines: Medicine
                Keywords: geriatric medicine,risk management,change management
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: geriatric medicine, risk management, change management

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