Introduction The frail elderly in Canada face a tough decision when they start to lose autonomy: whether to stay at home or move to another location. This study seeks to scale up and evaluate the implementation of shared decision-making (SDM) in interprofessional (IP) home care teams caring for elderly clients or their caregivers facing a decision about staying at home or moving elsewhere.
Methods A stepped wedge cluster randomised trial involving 8 Health and Social Service Centers (HSSCs) will be conducted with IP home care teams. HSSCs are the unit of randomisation. A decision guide will be passively distributed to all of the participating HSSCs at the beginning of the project. The participating HSSCs will then be randomised to 1 of 4 intervention start times, separated by 7-month intervals. The primary outcome is whether or not clients and caregivers assumed an active role in decision-making, assessed with a modified version of the Control Preferences Scale. The intervention, targeted at IP home care teams, consists of a 1.5 hour online tutorial and a 3.5 hour skills building workshop in IP SDM. Clients will be eligible for outcome assessment if they (1) are aged ≥65; (2) are receiving care from the IP home care team of the enrolled HSSCs; (3) have made a decision about whether to stay at home or move to another location during the recruitment periods; (4) are able to read, understand and write French or English; (5) can give informed consent. If clients are not able to provide informed consent, their primary caregiver will become the eligible participant.
Ethics and dissemination Ethics committee review approval has been obtained from the Multicenter Ethics Committee of CISSS-Laval. Results will be disseminated at conferences, on websites of team members and in peer-reviewed and professional journals intended for policymakers and managers.
Trial registration number NCT02592525, Pre-results.
- Frail elderly
- Home care services
- Shared decision making
- Interprofessional collaboration
- Knowledge translation
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Contributors FL, NB and DS conceived the study. GL provided guidance for the planned cost-effectiveness analyses. SDe, SDu and KDF provided guidance on the Interprofessional Shared Decision-making Model and the training workshop materials. L-PR, MT and ST provided guidance for the planned statistical analyses. PJD, HB and LR validated the relevance of the trial and provided guidance on the methods. GPG is coordinating the project. FL and GPG drafted the manuscript. All authors have read and approved the final version of the manuscript. FL is its guarantor.
Funding This research is funded by the Canadian Institutes of Health Research (Grant number: 201403MOP-325236-KTR-CFBA-19158), and also supported by the CIUSSS de la Capitale-Nationale (in kind contribution included in the CIHR grant).
Competing interests DS reports personal fees from Washington State Health Authority Patient Decision Aid certification programme, outside the submitted work.
Patient consent Obtained.
Ethics approval Centre intégré de santé et de services sociaux de Laval (CISSS de Laval).
Provenance and peer review Not commissioned; externally peer reviewed.
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