Prevention of AcuTe admIssioN algorithm (PATINA): study protocol of a stepped wedge randomized controlled trial.

Area of Science:

• Gerontology and Public Health
• Health Services Research
• Digital Health Interventions

Background:

• Aging populations present significant challenges to healthcare systems globally.
• Acute hospital admissions for older adults can lead to adverse outcomes, necessitating early risk identification.
• Preventive measures, including integrated care models, are crucial for managing the health of community-dwelling seniors.

Purpose of the Study:

• To assess the effectiveness of the PATINA algorithm and decision support tool in identifying older adults at increased risk of acute hospital admission.
• To evaluate the impact of the intervention on reducing acute admissions and improving preventive care.
• To explore barriers and facilitators to implementing such digital tools in community nursing.

Main Methods:

• A stepped-wedge cluster randomized controlled trial (SW-RCT) involving 20 home care teams across three Danish municipalities.
• The study includes approximately 6500 community-dwelling citizens aged 65 and above receiving home care.
• The PATINA tool uses an algorithm based on home care use to trigger alerts for nurses to systematically assess at-risk individuals.

Main Results:

• The primary outcome is the rate of acute hospital admissions.
• Secondary outcomes include readmissions, preventable admissions, mortality, and healthcare costs.
• The study will also investigate community nurses' acceptance and use of the algorithm.

Conclusions:

• The PATINA tool is expected to enhance nurses' awareness and decision-making, leading to increased preventive care.
• Implementation of the algorithm and decision support tool aims to reduce secondary healthcare utilization among older adults.
• Findings will contribute to understanding the implementation of digital health tools in community care settings.