Details of HTA project in progress
Last updated: 31 August 2010 - Next update due: 7 September 2010
Research type: |
Primary Research (e.g. trial) |
Project title: |
Care of older people who fall: evaluation of the clinical and cost effectiveness of new protocols for emergency ambulance personnel to assess and refer to appropriate community based care |
Project ref: |
07/01/21 |
Cost: |
£1,366,500 |
Chief Investigator : |
Professor Helen Snooks, Professor of Health Services Research, Centre for Health Information Research and Evaluation, Swansea University |
Start Date: |
April 2009 |
Estimated date of publication in HTA journal series: |
Late 2021. This date takes account of time for report preparation and printing based on current average times for these activities. |
Plain English Summary |
The proposed trial will measure the costs and benefits of a new health technology - a protocol for use by emergency ambulance paramedics in the care of older people who have fallen allowing the paramedic to assess and refer appropriate patients to a community based falls service. We will carry out a randomised controlled trial in which ambulance stations in three participating services (London, Wales, East Midlands) are randomly allocated to 1) implement the new health technology (intervention group) or 2) to continue to provide care according to their standard practice (control group). Paramedics based at the stations selected for the intervention group will receive additional training, protocols and clinical support to enable them to assess older people and decide whether they need to be taken to the Emergency Department (ED) straight away, or whether they could benefit from being left at home, with a referral to a falls service. We will compare costs, processes and outcomes of care for patients aged 65 or over who have fallen and are attended by paramedics with the new protocols with those attended by paramedics delivering usual care, at 1 and 6 months. The most important outcomes are those related to further falls - subsequent 999 calls and ED attendances for falls. We will also compare between groups: all falls; fall related injuries; hospital admissions; quality of life; 'fear of falling'; satisfaction; deaths; operational measures for the services e.g. time spent on jobs; and the costs of care (and any knock on effects) to the NHS and other services and to patients and carers. We will also gather in-depth information from patients, carers and health care providers (paramedics, ambulance service managers, and falls service staff) about how the new service works, and about any factors which encourage or hinder its use. There are ethical issues related to undertaking research with a vulnerable group such as this - we will not seek consent to participate in the study during the 999 call, or at the scene of the fall - but, subject to ethical approval, propose to write to eligible patients, about the research and to offer them the opportunity to opt out from follow up. Members of this highly experienced research team have previously collaborated on successful and influential studies in this area. The research costs include funding for a trial co-ordinator, to be based in Swansea and three research assistants, one to be based at each partner sites, as well as for the contribution of our specialist advisors in statistics, health economics, qualitative methods and clinical matters. NHS costs related to training, clinical support and implementation are also included. |
Project Abstract: |
The proposed trial will measure the costs and benefits of a new health technology - a protocol for use by emergency ambulance paramedics in the care of older people who have fallen allowing the paramedic to assess and refer appropriate patients to a community based falls service. We will carry out a randomised controlled trial in which ambulance stations in three participating services (London, Wales, East Midlands) are randomly allocated to 1) implement the new health technology (intervention group) or 2) to continue to provide care according to their standard practice (control group). Paramedics based at the stations selected for the intervention group will receive additional training, protocols and clinical support to enable them to assess older people and decide whether they need to be taken to the Emergency Department (ED) straight away, or whether they could benefit from being left at home, with a referral to a falls service. We will compare costs, processes and outcomes of care for patients aged 65 or over who have fallen and are attended by paramedics with the new protocols with those attended by paramedics delivering usual care, at 1 and 6 months. The most important outcomes are those related to further falls - subsequent 999 calls and ED attendances for falls. We will also compare between groups: all falls; fall related injuries; hospital admissions; quality of life; 'fear of falling'; satisfaction; deaths; operational measures for the services e.g. time spent on jobs; and the costs of care (and any knock on effects) to the NHS and other services and to patients and carers. We will also gather in-depth information from patients, carers and health care providers (paramedics, ambulance service managers, and falls service staff) about how the new service works, and about any factors which encourage or hinder its use |
ISRCTN* number: | ISRCTN 60481756 (*International Standard Randomised Controlled Trial Number) URL of this project on the Controlled Trials Website: http://www.controlled-trials.com/ISRCTN60481756 |
Project Protocol: |
Project protocol (pdf format, 231 kbytes) |
URL of this page: |
http://www.hta.ac.uk/1802 |
News feeds