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BMC Geriatrics
Published in: BMC Geriatrics 1/2021

Open Access 01-12-2021 | Study protocol

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

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

Published in: BMC Geriatrics | Issue 1/2021

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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.
Appendix
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Metadata
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
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
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2021
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-021-02585-0

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