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Trial registered on ANZCTR
Registration number
ACTRN12618001761257
Ethics application status
Approved
Date submitted
3/10/2018
Date registered
25/10/2018
Date last updated
1/10/2019
Date data sharing statement initially provided
1/10/2019
Type of registration
Retrospectively registered
Titles & IDs
Public title
Hospitalization Process Effects on Mobility Outcomes and Recovery
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Scientific title
Hospitalization Process Effects on Mobility Outcomes and Recovery
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Secondary ID [1]
296245
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none
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Universal Trial Number (UTN)
None
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Trial acronym
HoPE MOR
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
acute hospitalization
309899
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acute illness
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Condition category
Condition code
Public Health
308686
308686
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0
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Health service research
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Intervention/exposure
Study type
Observational
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Patient registry
True
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Target follow-up duration
4
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Target follow-up type
Weeks
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Description of intervention(s) / exposure
The exposure is acute hospitalization. Each participants is followed up to five days during the hospitalization period and after month via a phone call.
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Intervention code [1]
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Not applicable
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Comparator / control treatment
None
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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1. Subjective changes in functional status between 2 weeks prior to admission and discharge will be measured using the Modified Barthel Index (MBI).
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Assessment method [1]
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Timepoint [1]
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End of hospitalization
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Primary outcome [2]
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2, Functioning objectively using a mobility-associated functional status measure, the De Morton Mobility Index (DEMMI),
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Assessment method [2]
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Timepoint [2]
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discharge
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Secondary outcome [1]
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One month post discharge, Activities of Daily Living (IADLs), using MBI questioner.
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Assessment method [1]
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Timepoint [1]
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one month post hospitalization
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Secondary outcome [2]
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Alabama at Birmingham Life-Space Assessment (LSA), measuring community mobility.
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Assessment method [2]
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Timepoint [2]
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one month post discharge
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Eligibility
Key inclusion criteria
(1) age 70 or older, (2) self-reported pre-admission ability to walk with or without personal or assistive device, (3) cognitively intact or having available caregivers willing to participate based on intermediary reporting, and (4) the patient or the caregiver speaks Hebrew, Arabic, or Russian
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Minimum age
70
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
(1) Admission diagnosis of acute Cerbro Vascular Accident (CVA) (2) need for mechanical ventilation, (3) patient admitted for end-of-life care, (4) prescribed mobility restriction for 24 hours or longer, or (5) patient in prescribed isolation.
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Study design
Purpose
Natural history
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Duration
Longitudinal
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
Descriptive statistics: Descriptive statistics of variables will be obtained to understand the characteristics of the study population, to evaluate distribution of subjects across subgroups for stratified analyses (e.g., age and functioning subgroups), and to identify potential confounders (in addition to a priori selected confounders, such as ethnicity, illness severity, premorbid mobility) to inform subsequent analyses. We will evaluate associations between these variables and the variable of primary interest, in-hospital mobility.
Accounting for the nested design: As patients are nested within units/hospitals, some of the variation may be attributable to the unit’s/hospital’s characteristics; thus a nested design will be used. We will test the level of nesting using the Intraclass Correlation coefficient (ICC) and account for the nested design (patients within units/hospitals) using the generalized estimating equation (GEE) approach. GEE accounts for the correlation between observations in generalized linear regression models by use of an empirical (sandwich/robust) variance estimator. GEEs estimate regression coefficients and standard errors with sampling distributions that are asymptotically normal, can be applied to test main effects and interactions, and can be used to evaluate categorical or continuous independent variables. We will specify an “identity” link and test an exchangeable working correlation matrix against an independence correlation matrix and an unstructured correlation matrix for the model that fits best..
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
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Actual
1/03/2018
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
1000
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Accrual to date
200
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Final
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Recruitment outside Australia
Country [1]
20894
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Israel
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State/province [1]
20894
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Israel Science Foundation ISF
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Address [1]
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Jabotisky 31
Jerusalem 9104001
Israel
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Country [1]
300843
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Israel
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Primary sponsor type
University
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Name
University of Haifa
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Address
Abba Hushi Haifa 31905
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Country
Israel
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Secondary sponsor category [1]
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Hospital
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Name [1]
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HaEmek,
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Address [1]
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Afula (HaEMEK)
David 15 street
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Country [1]
300391
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Israel
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Secondary sponsor category [2]
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Hospital
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Name [2]
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Carmel,
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Address [2]
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Michal 7
Haifa Israel
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Country [2]
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Israel
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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University of Haifa IRB board
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Ethics committee address [1]
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Abba Hushi 140 Haifa Israel
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Ethics committee country [1]
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Israel
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Date submitted for ethics approval [1]
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04/10/2017
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Approval date [1]
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31/10/2017
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Ethics approval number [1]
301611
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Summary
Brief summary
For hospitalized older adults, every day of immobility is associated with reduced muscle mass and strength, leading to a host of negative outcomes, including short- and long-term functional decline. Despite the established knowledge of the deleterious effects of immobility, older adults, even those able to ambulate independently, spend most of their hospital stay lying in bed. Emergent evidence suggests that in-hospital immobility is a complex phenomenon affected by a wide range of factors, such as personal predisposing characteristics, intrinsically related to patients’ clinical, physical, mental, and emotional condition; and hospitalization process factors, related to the care processes, the characteristics of the healthcare organization, and the assistance of informal caregiving. Nonetheless, a comprehensive model postulating the relative contribution of and interrelations between these risk factors has yet to be proposed and empirically tested. Moreover, despite increasing realization of the importance of tailoring mobility recommendations that account for patients’ predisposing clinical and functional conditions, specific mobility thresholds are yet to be established. To achieve this goal, we will conduct a prospective multi-center study of 1,200 hospitalized older adults nested in 40 internal medical units in nine hospitals across Israel and a sample of 340 nurses, nurse aides, and physicians from these units. Data will be collected in five phases: (1) prior to patients’ recruitment, on the hospital setting and on staff knowledge and attitudes; (2) at admission, on personal risk factors including physical, medical, and cognitive function; (3) during the hospitalization period, on healthcare and caregiving-related factors (from patient-survey and electronic health record data) and on actual mobility levels (assessed up to 5 hospitalization days using accelerometers); (4) at discharge, on physical, medical, and cognitive function; (5) and 1 month post-discharge via a telephone interview, on hospitalization outcomes. Analysis will employ multiple linear regressions and structural equation modeling, accounting for the multilevel design.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Maayan Agmon
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Address
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Abba Hushi 140
University of Haifa
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Country
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Israel
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Phone
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+972549001609
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Maayan Agmon
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Address
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Abba Hushi 140
University of Haifa
Haifa Israel
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Country
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Israel
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Phone
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+972549001609
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Maayan Agmon
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Address
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Abba Hushi 140
University of Haifa
Haifa Israel
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Country
87552
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Israel
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Phone
87552
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+972549001609
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Fax
87552
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
5088
Study protocol
[email protected]
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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