COMPREHENSIVE CARE FOR OLDER ADULTS: CASE MANAGEMENT APPROACH

IntroductionEmergency department (ED)-initiated palliative care has been shown to improve patient-centred outcomes in older adults with serious, life-limiting illnesses. However, the optimal modality for providing such interventions is unknown. This study aims to compare nurse-led telephonic case management to specialty outpatient palliative care for older adults with serious, life-limiting illness on: (1) quality of life in patients; (2) healthcare utilisation; (3) loneliness and symptom burden and (4) caregiver strain, caregiver quality of life and bereavement.Methods and analysisThis is a protocol for a pragmatic, multicentre, parallel, two-arm randomised controlled trial in ED patients comparing two established models of palliative care: nurse-led telephonic case management and specialty, outpatient palliative care. We will enrol 1350 patients aged 50+ years and 675 of their caregivers across nine EDs. Eligible patients: (1) have advanced cancer (metastatic solid tumour) or end-stage organ failure (New York Heart Association class III or IV heart failure, end-stage renal disease with glomerular filtration rate <15 mL/min/m2, or global initiative for chronic obstructive lung disease stage III, IV or oxygen-dependent chronic obstructive pulmonary disease); (2) speak English; (3) are scheduled for ED discharge or observation status; (4) reside locally; (5) have a working telephone and (6) are insured. Patients will be excluded if they: (1) have dementia; (2) have received hospice care or two or more palliative care visits in the last 6 months or (3) reside in a long-term care facility. We will use patient-level block randomisation, stratified by ED site and disease. Effectiveness will be compared by measuring the impact of each intervention on the specified outcomes. The primary outcome will measure change in patient quality of life.Ethics and disseminationInstitutional Review Board approval was obtained at all study sites. Trial results will be submitted for publication in a peer-reviewed journal.Trial registration numberNCT03325985; Pre-results.

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Case management for home-bound older adults in New York City: what is an appropriate caseload size?

Educational Gerontology ◽

10.1080/03601277.2018.1555205 ◽

2018 ◽

Vol 44 (11) ◽

pp. 712-723

Author(s):

Manoj Pardasani

Keyword(s):

Older Adults ◽

New York ◽

New York City ◽

Case Management ◽

York City

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Capitation Financing for the Chronic Mentally Ill: A Case Management Approach

Psychiatric Services ◽

10.1176/ps.39.1.68 ◽

1988 ◽

Vol 39 (1) ◽

pp. 68-72 ◽

Cited By ~ 1

Author(s):

Maxine Harris ◽

Helen C. Bergman

Keyword(s):

Case Management ◽

Mentally Ill ◽

Management Approach

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AIDS: A case management approach. The illinois experience

Child and Adolescent Social Work Journal ◽

10.1007/bf00756463 ◽

1987 ◽

Vol 4 (3-4) ◽

pp. 130-141 ◽

Cited By ~ 1

Author(s):

Peggy Magee ◽

Florence L. Senizaiz

Keyword(s):

Case Management ◽

Management Approach

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Nonarteritic Ischemic Optic Neuropathy

Neuro-Ophthalmology ◽

10.1093/med/9780190603953.003.0003 ◽

2019 ◽

pp. 15-20

Author(s):

Matthew J. Thurtell ◽

Robert L. Tomsak

Keyword(s):

Risk Factors ◽

Older Adults ◽

Optic Neuropathy ◽

Acute Onset ◽

Anterior Ischemic Optic Neuropathy ◽

Management Approach ◽

Ischemic Optic Neuropathy ◽

Common Condition ◽

Fellow Eye ◽

Eye Involvement

Nonarteritic anterior ischemic optic neuropathy is the most frequent cause of acute-onset optic neuropathy in older adults. Its exact pathogenesis remains uncertain, although it often occurs in patients with a small, structurally congested optic disc (“disc at risk”). In this chapter, we begin by reviewing the clinical features of nonarteritic anterior ischemic optic neuropathy. We then discuss the prognosis for recovery of vision and fellow eye involvement. We review the risk factors and precipitating factors for this condition. We list the medications that have been associated with this condition. Lastly, we review the workup and management approach for this common condition.

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A randomised controlled trial of a case management approach to encourage participation in colorectal cancer screening for people with schizophrenia in psychiatric outpatient clinics: study protocol for the J-SUPPORT 1901 (ACCESS) study

BMJ Open ◽

10.1136/bmjopen-2019-032955 ◽

2019 ◽

Vol 9 (11) ◽

pp. e032955

Author(s):

Masaki Fujiwara ◽

Masatoshi Inagaki ◽

Taichi Shimazu ◽

Masafumi Kodama ◽

Ryuhei So ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Screening ◽

Case Management ◽

Colorectal Cancer Screening ◽

Personal Information ◽

Controlled Trial ◽

University Hospital ◽

Management Approach ◽

Ethical Guidelines ◽

Delay In Diagnosis

IntroductionOne of the reasons for the high mortality rate from cancer in people with schizophrenia is delay in diagnosis. Many studies have shown lower cancer screening rates in people with schizophrenia; however, there are no interventions for people with schizophrenia to increase cancer screening. Therefore, we developed a case management (CM) intervention to encourage participation in cancer screening. The purpose of this study was to examine the efficacy of CM to encourage participation in cancer screening for people with schizophrenia, with particular focus on colorectal cancer screening by faecal occult blood testing, compared with usual intervention (UI), namely, municipal public education.Methods and analysisThis is an individually randomised, parallel group trial with blinded outcome assessments. The participants will be randomly allocated to either the CM plus UI group or UI alone group in a 1:1 ratio using a web-based program at a data management centre. The primary end point of the study is participation in colorectal cancer screening in the year of intervention, which will be assessed based on municipal records.Ethics and disseminationThis study is performed in accordance with Ethical Guidelines for Medical and Health Research Involving Human Subjects published by Japan’s Ministry of Education, Science, and Technology and the Ministry of Health, Labour, and Welfare and the modified Act on the Protection of Personal Information as well as the Declaration of Helsinki. This study was approved by the institutional ethics committee at the Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences and Okayama University Hospital on 23 April 2019 (approval number: RIN1904-003). The findings of this trial will be submitted to an international peer-reviewed journal.Trial registration numberUMIN000036017.

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