Virtual Care for Frailty After Surgery (VICTORY Trial)
Recruiting in Palo Alto (17 mi)
Overseen BySylvie Aucoin, MD
Age: 18+
Sex: Any
Travel: May be covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Ottawa Hospital Research Institute
No Placebo Group
Trial Summary
What is the purpose of this trial?Canadian hospitals continue to struggle with severe emergency department and hospital bed capacity shortages. Maximizing bed availability and minimizing emergency department and urgent-centre visits by providing patients with alternative options to care is an important part of the solution. Surgical patients with frailty are at high risk of requiring subsequent acute-hospital care. The VICTORY trial will answer an important question that will inform how to improve care for surgical patients with frailty by determining the effect of virtual care with CloudDX technology compared to standard care to see if it can result in an increase in the number of days alive and at home that older people with frailty experience after planned surgery.
How is the CloudDX technology treatment unique for managing frailty after surgery?
CloudDX technology offers a novel approach by utilizing virtual care to monitor and manage frailty after surgery, potentially providing continuous and remote support that traditional in-person methods may not offer. This technology leverages electronic health data to assess frailty, which can be more efficient and less resource-intensive compared to conventional frailty screening tools.
34567What data supports the effectiveness of the treatment CloudDX technology for frailty after surgery?
Research shows that rehabilitation strategies after surgery can improve outcomes for frail patients by building strength. Additionally, preoperative exercise, like walking with an activity tracker, can enhance stamina and mobility, which may help in recovery after surgery.
12568Do I need to stop my current medications for the trial?
The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.
Eligibility Criteria
The VICTORY trial is for people over 60 with frailty (Clinical Frailty Score >4) who are scheduled for elective surgery and speak English. It's not specified who can't join, but typically those with conditions that could interfere with virtual care or follow-up might be excluded.Inclusion Criteria
I am over 60 years old.
I am planning to have elective surgery.
Participant Groups
This study tests if virtual care using CloudDX technology improves the number of days older adults with frailty spend at home after planned surgery, compared to standard post-surgical care. Participants will receive either the new virtual care method or usual care.
2Treatment groups
Experimental Treatment
Active Control
Group I: Virtual CareExperimental Treatment1 Intervention
Intervention group participants will be enrolled in a PVC program prior to admission, including receipt of a cellular-enabled tablet and Cloud DX remote monitoring equipment.
Through Cloud DX remote monitoring technology, intervention group participants will receive the following intervention: remote automated monitoring, frailty-tailored daily symptom survey, Katz Index of Independence in Activities of Daily Living survey, FAM-CAM survey, Virtual RN assessment, medications.
Group II: Standard CareActive Control1 Intervention
The standard care group will receive their post-hospital discharge management in alignment with standard of care at the hospital where they had surgery.
Find A Clinic Near You
Research locations nearbySelect from list below to view details:
The Ottawa HospitalOttawa, Canada
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Who is running the clinical trial?
Ottawa Hospital Research InstituteLead Sponsor
References
Impact of frailty on outcomes after discharge in older surgical patients: a prospective cohort study. [2019]Frailty is a state of vulnerability to diverse stressors. We assessed the impact of frailty on outcomes after discharge in older surgical patients.
The prevalence of frailty and its association with clinical outcomes in general surgery: a systematic review and meta-analysis. [2019]to investigate the prevalence and impact of frailty for general surgical patients.
Association Between Patient-Reported Frailty and Non-Home Discharge Among Older Adults Undergoing Surgery. [2022]Identifying surgical patients at risk for discharge to a post-acute facility has the potential to reduce hospital length of stay, improve postoperative planning, and increase patient satisfaction. We sought to examine the association between a positive response to a preoperative patient-reported frailty screen and non-home discharge (NHD).
A Systematic Review and Meta-Analysis of Preoperative Frailty Instruments Derived From Electronic Health Data. [2023]Frailty is a strong predictor of adverse outcomes in the perioperative period. Given the increasing availability of electronic medical data, we performed a systematic review and meta-analysis with primary objectives of describing available frailty instruments applied to electronic data and synthesizing their prognostic value. Our secondary objectives were to assess the construct validity of frailty instruments that have been applied to perioperative electronic data and the feasibility of electronic frailty assessment.
Supervised preoperative walking on increasing early postoperative stamina and mobility in older adults with frailty traits: A pilot and feasibility study. [2022]Frail older adults are more than twice as likely to experience postoperative complications. Preoperative exercise may better prepare these patients through improved stamina and mobility experienced in the days following surgery. We measured the impact of a walking intervention using an activity tracker and coaching on postoperative stamina, and mobility in older adults with frailty traits.
Automated Electronic Frailty Index is Associated with Non-home Discharge in Patients Undergoing Open Revascularization for Peripheral Vascular Disease. [2023]Frailty is associated with adverse surgical outcomes including post-operative complications, needs for post-acute care, and mortality. While multiple frailty screening tools exist, most are time and resource intensive. Here we examine the association of an automated electronic frailty index (eFI), derived from routine data in the Electronic Health Record (EHR), with outcomes in vascular surgery patients undergoing open, lower extremity revascularization.
Perceptions and practices surrounding the perioperative management of frail emergency surgery patients: a WSES-endorsed cross-sectional qualitative survey. [2023]Frailty is associated with poor post-operative outcomes in emergency surgical patients. Shared multidisciplinary models have been developed to provide a holistic, reactive model of care to improve outcomes for older people living with frailty. We aimed to describe current perioperative practices, and surgeons' awareness and perception of perioperative frailty management, and barriers to its implementation.
Preoperative Rehabilitation Is Feasible in the Weeks Prior to Surgery and Significantly Improves Functional Performance. [2023]Frailty is a multidimensional state of increased vulnerability. Frail patients are at increased risk for poor surgical outcomes. Prior research demonstrates that rehabilitation strategies deployed after surgery improve outcomes by building strength.