A complex intervention to promote prevention of delirium in older adults by targeting caregiver’s participation during and after hospital discharge – study protocol of the TRAnsport and DElirium in older people (TRADE) project

Abstract Background Among potentially modifiable risk factors for delirium, transfers between wards, hospitals and other facilities have been mentioned with low evidence. TRADE (TRAnsport and DElirium in older people) was set up to investigate i) the impact of transfer and/or discharge on the onset...

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Main Authors: Christoph Leinert, Simone Brefka, Ulrike Braisch, Natascha Denninger, Martin Mueller, Petra Benzinger, Juergen Bauer, Anke Bahrmann, Norbert Frey, Hugo A. Katus, Tobias Geisler, Gerhard Eschweiler, Jochen Klaus, Thomas Seufferlein, Konrad Schuetze, Florian Gebhard, Jens Dreyhaupt, Rainer Muche, Kathrin Pahmeier, Janine Biermann-Stallwitz, Juergen Wasem, Lena Flagmeier, Dhayana Dallmeier, Michael Denkinger
Format: Article
Language:English
Published: BMC 2021-11-01
Series:BMC Geriatrics
Subjects:
Online Access:https://doi.org/10.1186/s12877-021-02585-0
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author Christoph Leinert
Simone Brefka
Ulrike Braisch
Natascha Denninger
Martin Mueller
Petra Benzinger
Juergen Bauer
Anke Bahrmann
Norbert Frey
Hugo A. Katus
Tobias Geisler
Gerhard Eschweiler
Jochen Klaus
Thomas Seufferlein
Konrad Schuetze
Florian Gebhard
Jens Dreyhaupt
Rainer Muche
Kathrin Pahmeier
Janine Biermann-Stallwitz
Juergen Wasem
Lena Flagmeier
Dhayana Dallmeier
Michael Denkinger
author_facet Christoph Leinert
Simone Brefka
Ulrike Braisch
Natascha Denninger
Martin Mueller
Petra Benzinger
Juergen Bauer
Anke Bahrmann
Norbert Frey
Hugo A. Katus
Tobias Geisler
Gerhard Eschweiler
Jochen Klaus
Thomas Seufferlein
Konrad Schuetze
Florian Gebhard
Jens Dreyhaupt
Rainer Muche
Kathrin Pahmeier
Janine Biermann-Stallwitz
Juergen Wasem
Lena Flagmeier
Dhayana Dallmeier
Michael Denkinger
author_sort Christoph Leinert
collection DOAJ
description Abstract Background Among potentially modifiable risk factors for delirium, transfers between wards, hospitals and other facilities have been mentioned with low evidence. TRADE (TRAnsport and DElirium in older people) was set up to investigate i) the impact of transfer and/or discharge on the onset of delirium in older adults and ii) feasibility and acceptance of a developed complex intervention targeting caregiver’s participation during and after hospital discharge or transfer on cognition and the onset of delirium in older adults. Methods The study is designed according to the guidelines of the UK Medical Research Council (MRC) for development and evaluation of complex interventions and comprises two steps: development and feasibility/piloting. The development phase includes i) a multicenter observational prospective cohort study to assess delirium incidence and cognitive decline associated with transfer and discharge, ii) a systematic review of the literature, iii) stakeholder focus group interviews and iv) an expert workshop followed by a Delphi survey. Based on this information, a complex intervention to better and systematically involve family caregivers in discharge and transport was developed. The intervention will be tested in a pilot study using a stepped wedge design with a detailed process and health economic evaluation. The study is conducted at four acute care hospitals in southwest Germany. Primary endpoints are the delirium incidence and cognitive function. Secondary endpoints include prevalence of caregiver companionship, functional decline, cost and cost effectiveness, quality of discharge management and quality of admission management in admitting hospitals or nursing homes. Data will be collected prior to discharge as well as after 3, 7 and 90 days. Discussion TRADE will help to evaluate transfer and discharge as a possible risk factor for delirium. In addition, TRADE evaluates the impact and modifiability of caregiver’s participation during patient’s transfer or discharge on delirium incidence and cognitive decline providing the foundation for a confirmatory implementation study. Trial registration DRKS (Deutsches Register für klinische Studien) DRKS00017828 . Registered on 17th September 2019. Retrospectively registered.
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spelling doaj.art-88ecd5af7451477289bc0a6e8c9558d02022-12-21T23:38:14ZengBMCBMC Geriatrics1471-23182021-11-0121111510.1186/s12877-021-02585-0A complex intervention to promote prevention of delirium in older adults by targeting caregiver’s participation during and after hospital discharge – study protocol of the TRAnsport and DElirium in older people (TRADE) projectChristoph Leinert0Simone Brefka1Ulrike Braisch2Natascha Denninger3Martin Mueller4Petra Benzinger5Juergen Bauer6Anke Bahrmann7Norbert Frey8Hugo A. Katus9Tobias Geisler10Gerhard Eschweiler11Jochen Klaus12Thomas Seufferlein13Konrad Schuetze14Florian Gebhard15Jens Dreyhaupt16Rainer Muche17Kathrin Pahmeier18Janine Biermann-Stallwitz19Juergen Wasem20Lena Flagmeier21Dhayana Dallmeier22Michael Denkinger23Agaplesion Bethesda Clinic UlmAgaplesion Bethesda Clinic UlmAgaplesion Bethesda Clinic UlmCenter for Research, Development and Transfer, Rosenheim Technical University of Applied SciencesFaculty of Applied Health and Social Sciences, Rosenheim Technical University of Applied SciencesCenter for Geriatric Medicine, Agaplesion Bethanien Krankenhaus Heidelberg, Heidelberg UniversityCenter for Geriatric Medicine, Agaplesion Bethanien Krankenhaus Heidelberg, Heidelberg UniversityDepartment of Cardiology, Angiology and Pneumology, University Hospital of HeidelbergDepartment of Cardiology, Angiology and Pneumology, University Hospital of HeidelbergDepartment of Internal Medicine, University Hospital of HeidelbergDepartment of Cardiology, University Hospital TuebingenGeriatric Center at the University Hospital TuebingenDepartment of Medicine I, University Hospital UlmDepartment of Medicine I, University Hospital UlmDepartment of Trauma-, Hand-, and Reconstructive Surgery, Ulm UniversityDepartment of Trauma-, Hand-, and Reconstructive Surgery, Ulm UniversityInstitute of Epidemiology and Medical Biometry, Ulm UniversityInstitute of Epidemiology and Medical Biometry, Ulm UniversityInstitute for Health Care Management and Research, University of Duisburg-EssenInstitute for Health Care Management and Research, University of Duisburg-EssenInstitute for Health Care Management and Research, University of Duisburg-EssenAOK – Allgemeine Ortskrankenkasse Baden-WuerttembergAgaplesion Bethesda Clinic UlmAgaplesion Bethesda Clinic UlmAbstract Background Among potentially modifiable risk factors for delirium, transfers between wards, hospitals and other facilities have been mentioned with low evidence. TRADE (TRAnsport and DElirium in older people) was set up to investigate i) the impact of transfer and/or discharge on the onset of delirium in older adults and ii) feasibility and acceptance of a developed complex intervention targeting caregiver’s participation during and after hospital discharge or transfer on cognition and the onset of delirium in older adults. Methods The study is designed according to the guidelines of the UK Medical Research Council (MRC) for development and evaluation of complex interventions and comprises two steps: development and feasibility/piloting. The development phase includes i) a multicenter observational prospective cohort study to assess delirium incidence and cognitive decline associated with transfer and discharge, ii) a systematic review of the literature, iii) stakeholder focus group interviews and iv) an expert workshop followed by a Delphi survey. Based on this information, a complex intervention to better and systematically involve family caregivers in discharge and transport was developed. The intervention will be tested in a pilot study using a stepped wedge design with a detailed process and health economic evaluation. The study is conducted at four acute care hospitals in southwest Germany. Primary endpoints are the delirium incidence and cognitive function. Secondary endpoints include prevalence of caregiver companionship, functional decline, cost and cost effectiveness, quality of discharge management and quality of admission management in admitting hospitals or nursing homes. Data will be collected prior to discharge as well as after 3, 7 and 90 days. Discussion TRADE will help to evaluate transfer and discharge as a possible risk factor for delirium. In addition, TRADE evaluates the impact and modifiability of caregiver’s participation during patient’s transfer or discharge on delirium incidence and cognitive decline providing the foundation for a confirmatory implementation study. Trial registration DRKS (Deutsches Register für klinische Studien) DRKS00017828 . Registered on 17th September 2019. Retrospectively registered.https://doi.org/10.1186/s12877-021-02585-0CaregiverComplex interventionDeliriumDementiaDischargeFamily
spellingShingle Christoph Leinert
Simone Brefka
Ulrike Braisch
Natascha Denninger
Martin Mueller
Petra Benzinger
Juergen Bauer
Anke Bahrmann
Norbert Frey
Hugo A. Katus
Tobias Geisler
Gerhard Eschweiler
Jochen Klaus
Thomas Seufferlein
Konrad Schuetze
Florian Gebhard
Jens Dreyhaupt
Rainer Muche
Kathrin Pahmeier
Janine Biermann-Stallwitz
Juergen Wasem
Lena Flagmeier
Dhayana Dallmeier
Michael Denkinger
A complex intervention to promote prevention of delirium in older adults by targeting caregiver’s participation during and after hospital discharge – study protocol of the TRAnsport and DElirium in older people (TRADE) project
BMC Geriatrics
Caregiver
Complex intervention
Delirium
Dementia
Discharge
Family
title A complex intervention to promote prevention of delirium in older adults by targeting caregiver’s participation during and after hospital discharge – study protocol of the TRAnsport and DElirium in older people (TRADE) project
title_full A complex intervention to promote prevention of delirium in older adults by targeting caregiver’s participation during and after hospital discharge – study protocol of the TRAnsport and DElirium in older people (TRADE) project
title_fullStr A complex intervention to promote prevention of delirium in older adults by targeting caregiver’s participation during and after hospital discharge – study protocol of the TRAnsport and DElirium in older people (TRADE) project
title_full_unstemmed A complex intervention to promote prevention of delirium in older adults by targeting caregiver’s participation during and after hospital discharge – study protocol of the TRAnsport and DElirium in older people (TRADE) project
title_short A complex intervention to promote prevention of delirium in older adults by targeting caregiver’s participation during and after hospital discharge – study protocol of the TRAnsport and DElirium in older people (TRADE) project
title_sort complex intervention to promote prevention of delirium in older adults by targeting caregiver s participation during and after hospital discharge study protocol of the transport and delirium in older people trade project
topic Caregiver
Complex intervention
Delirium
Dementia
Discharge
Family
url https://doi.org/10.1186/s12877-021-02585-0
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