Clinical and process outcomes for older adults in the Geriatric Emergency Medicine Unit (GEM-U)

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This is a prospective cohort study that follows patients aged 75 and older who pass through the Geriatric Emergency Medicine Unit and are reviewed by the Older Persons Integrated Care Team. Participants who screen positive on ISAR (≥2) and present with a medical problem are enrolled and characterized using comprehensive geriatric assessment tools including the Barthel Index, 4AT (± Delirium Rating Scale), Clinical Frailty Scale, Mini Nutritional Assessment, EQ-5D-5L, and PSQ-18. Clinical and process outcomes such as acute hospital admission, function, nutrition, delirium, frailty status, quality of life, and patient satisfaction are recorded at baseline, 30 days, and 6 months. All participants provide informed consent, reporting follows STROBE guidelines, and data will be analyzed statistically to describe outcomes and associations.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Older adults aged ≥75 years
* Manchester Triage System category 2-5
* Screen positive for risk of adverse outcomes after ED visit (≥ 2 on ISAR screening tool)
* Presenting with a medical condition
* Reviewed by the Older Persons Integrated Care Team

Exclusion Criteria:

* Patients presenting with a non-medical issue including major trauma or hip fracture

  * Patients presenting with acute stroke or transient ischaemic attack
  * Patients more appropriate to another alternative pathway e.g. deep vein thrombosis pathway, low risk chest pain pathway
  * Patients with acute coronary syndrome or unstable arrthymia
  * Patients requiring care in the resuscitation room
  * Patients with head injury (unless appropriate assessment and management has been fully completed by ED team)
  * Patients with possible spinal injury (unless appropriate assessment and management has been fully completed by ED/orthopaedic team)
  * Patients with low Glasgow Coma Scale
  * Other exclusions at the discretion of the Older Persons Integrated Care team depending on team capacity and expertise
  * Exclusion criteria as set out above, are in line with those set out in the UHL Operating Policy of the Older Persons Integrated Care Team.

Where it's running

• University Hospital Limerick
  Limerick, Munster, Ireland Recruiting

Study contacts

• Principal investigator: Ida Carroll — University of Limerick
• Study coordinator: Ida M Carroll, MSc
• Email: 09006791@studentmail.ul.ie
• Phone: 0860638269

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.