Geneva School of Health Sciences, HES-SO, University of Applied Sciences and Arts Western Switzerland, Avenue de Champel 47, 1206, Geneva, Switzerland.
Geneva Institution for Homecare and Assistance (imad), Avenue du Cardinal Mermillod 36, 1227, Carouge, Switzerland.
BMC Geriatr. 2019 Aug 5;19(1):207. doi: 10.1186/s12877-019-1230-z.
The early screening of frail individuals and of patients with complex care needs are challenges that countries witnessing population aging face. Homecare nurses are actors of choice in meeting these challenges, yet they need means of identifying frail and complex patients in their routine practice. The fraXity study's aim is to fill this gap by (1) proposing frailty and complexity computation algorithms derived from the interRAI-HC; (2) assessing the predictive validity of the proposed indices with respect to adverse health outcomes; and (3) identifying subgroups of the aged population for whom the early screening of frailty and complexity appears to be most relevant.
The study will rely on a prospective observational case-control longitudinal study. Three samples of individuals aged 65 or older living in the community will be considered: recipients of formal home care (case 1), of formal home assistance (case 2) and individuals free of formal home services (controls). All participants will receive interRAI-HC assessments at three measurement occasions, separated by six-month intervals. Baseline assessments will serve to derive frailty and complexity scores. Follow-ups will serve to assess the predictive validity of the proposed indices and to estimate the intra-individual change in frailty and complexity. Group comparisons will serve to identify subgroups of the population for whom the screening of frailty and complexity appears to be the most relevant.
The expected results of the fraXity study are a) reliable computation algorithms for frailty and complexity scores derived from the interRAI-HC and b) clinical assessment protocols for use by homecare nurses. These outcomes should contribute to outfitting key actors of the health system with means of enhancing their part in a collective endeavor targeting the best care and quality of life for aged citizens.
ClinicalTrials.gov, NCT03883425 , registered on March 20, 2019.
人口老龄化国家面临的挑战包括对体弱个体和有复杂护理需求患者的早期筛查。家庭护理护士是应对这些挑战的首选角色，但他们需要在日常实践中识别体弱和复杂的患者。fraXity 研究旨在通过以下三个方面填补这一空白：（1）提出基于 interRAI-HC 的衰弱和复杂性计算算法；（2）评估所提出的指标对不良健康结果的预测有效性；（3）确定需要早期筛查衰弱和复杂性的老年人群亚组。
该研究将依赖于一项前瞻性观察性病例对照纵向研究。将考虑三组年龄在 65 岁或以上、居住在社区中的个体：接受正规家庭护理的个体（病例 1）、接受正规家庭援助的个体（病例 2）和无正规家庭服务的个体（对照组）。所有参与者将在三个测量时间点接受 interRAI-HC 评估，间隔六个月。基线评估将用于推导衰弱和复杂性评分。随访将用于评估所提出指标的预测有效性，并估计衰弱和复杂性的个体内变化。组间比较将用于确定需要早期筛查衰弱和复杂性的人群亚组。
fraXity 研究的预期结果是：a）基于 interRAI-HC 的衰弱和复杂性评分的可靠计算算法；b）家庭护理护士使用的临床评估方案。这些结果应有助于为卫生系统的关键参与者配备手段，以增强他们在集体努力中的作用，为老年公民提供最佳护理和生活质量。
ClinicalTrials.gov，NCT03883425，于 2019 年 3 月 20 日注册。
