<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT01703689</url>
  </required_header>
  <id_info>
    <org_study_id>ARSMP.2010.1</org_study_id>
    <nct_id>NCT01703689</nct_id>
  </id_info>
  <brief_title>Impact of Educational and Professional Supportive Interventions on Nursing Home Quality Indicators</brief_title>
  <acronym>IQUARE</acronym>
  <official_title>Impact of Either Audit and Feedback Only or Audit and Feedback Associated to Cooperative Work Meetings Between Hospital Geriatricians and Nursing Home Staff on Quality Indicators and Health Care Practices in Nursing Homes.</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Agence Régionale de la Santé - Midi Pyrénées</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
    <collaborator>
      <agency>Observatoire Régional de la Santé Midi-Pyrénées (ORSMIP)</agency>
      <agency_class>Other</agency_class>
    </collaborator>
  </sponsors>
  <source>Agence Régionale de la Santé - Midi Pyrénées</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
  </oversight_info>
  <brief_summary>
    <textblock>
      Introduction: Efficacy of audit and feedback interventions on nursing home (NH)quality&#xD;
      indicators is not well-established.&#xD;
&#xD;
      The main objective: The main purpose of the IQUARE study was to examine the impact of two&#xD;
      types of audit and feedback interventions on NH quality indicators and on residents&#xD;
      dependence levels in a 18-month follow-up.&#xD;
&#xD;
      Study hypothesis: We hypothesised that audit and feedback associated to educational and&#xD;
      professional supportive interventions are more efficacy in improving NH quality indicators&#xD;
      than audit and feedback only.&#xD;
&#xD;
      Secondary objectives: Investigate the impact of the interventions on&#xD;
&#xD;
        1. Residents:&#xD;
&#xD;
             -  Functional decline rate&#xD;
&#xD;
             -  Drug prescriptions (quantity and quality)&#xD;
&#xD;
             -  Prevalence of adverse health outcomes (e.g., falls)&#xD;
&#xD;
        2. NHs:&#xD;
&#xD;
             -  Planning and implementation of therapeutic measures&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      IQUARE is a multicentric individually-tailored controlled trial comparing two types of audit&#xD;
      and feedback interventions:&#xD;
&#xD;
        -  audit and feedback associated to cooperative work meetings between hospital&#xD;
           geriatricians and nursing home (NH) staff in a 6-month intervention (strong&#xD;
           intervention)&#xD;
&#xD;
        -  audit and feedback only (light intervention) Power statistics and sample size&#xD;
           calculations indicated that each group should be composed of at least 2 500 individuals.&#xD;
           The strong intervention will last 6 months and is composed of two face-to-face&#xD;
           cooperative meetings (hospital geriatricians and NH staff). Data will be collected at&#xD;
           baseline and in a 18-month follow-up.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Completed</overall_status>
  <start_date>May 2011</start_date>
  <completion_date type="Actual">March 2013</completion_date>
  <primary_completion_date type="Actual">July 2011</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Non-Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <primary_purpose>Health Services Research</primary_purpose>
    <masking>Single (Outcomes Assessor)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Change from baseline in nursing home quality indicators at 18 months</measure>
    <time_frame>baseline and 18-month follow-up</time_frame>
    <description>Indicators of quality of care in 10 main outcomes: dementia (e.g.,prevalence of cognitive assessment), behavioural disturbances (e.g., prevalence of behavioural disturbances assessment), restraining (e.g., prevalence of restrained residents with a medical prescription for restraining), mood (e.g., prevalence of mood assessment), osteoporosis and falls (e.g., systematic analysis of fall records), nutrition (e.g., prevalence of residents who were weighed ≥ 3 times in the last 3 months), pressure ulcers (e.g., prevalence of residents who were evaluated for the risk of pressure ulcers), pain (e.g., prevalence of residents who were evaluated for pain among residents in end-of-life), medication (e.g., prevalence of re-evaluation of residents' drug prescriptions among residents who take psychotropic), and care and services (e.g., prevalence of hospitalisations in the emergency department in the last 12 months).</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Onset of dependence in activities of daily living from baseline to 18 months follow-up</measure>
    <time_frame>baseline and 18-month follow-up</time_frame>
    <description>Onset of dependence will be measured using the 6-item Katz ADL scale. Activities examined are: bathing, dressing, transferring, walking inside home, incontinence, and eating/drinking. Ability in executing each activity will be set as: &quot;able to execute alone, without difficulty&quot;, &quot;able to execute alone, with some difficulty&quot;, or &quot;needing help to execute or unable to execute&quot;.</description>
  </secondary_outcome>
  <other_outcome>
    <measure>Reduction in the prescription of psychotropic drugs from baseline to 18-month follow-up</measure>
    <time_frame>baseline and 18-month follow-up</time_frame>
    <description>It will be examined if the rate of antidepressants, anxiolytics, antipsychotics, and hypnotics/sedatives (coded according to the Anatomical Therapeutic Chemical classification. Information available at: http://www.whocc.no/atc_ddd_index/) prescriptions will be reduced between baseline and follow-up. A particular attention will be given to the prevalence of people taking 3 or more psychotropics (increased risk of drug-drug interaction and adverse drug reaction) and to the use of these medications among people with dementia.</description>
  </other_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Actual">8039</enrollment>
  <condition>Quality Indicators</condition>
  <condition>Physical Disability</condition>
  <arm_group>
    <arm_group_label>strong intervention group (SIG)</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>Nursing homes that received audit and feedback information on quality indicators and benefited of cooperative work meetings with hospital geriatricians</description>
  </arm_group>
  <arm_group>
    <arm_group_label>intervention group (LIG)</arm_group_label>
    <arm_group_type>Active Comparator</arm_group_type>
    <description>Nursing homes that only received audit and feedback information on quality indicators</description>
  </arm_group>
  <intervention>
    <intervention_type>Behavioral</intervention_type>
    <intervention_name>Audit and Feedback</intervention_name>
    <description>Descriptive statistics to each nursing home (NH) with regards to its own indicators of quality and residents' health status, and the same descriptive statistics on the sub-regional and regional levels were done to all NHs for comparative purposes.</description>
    <arm_group_label>intervention group (LIG)</arm_group_label>
    <arm_group_label>strong intervention group (SIG)</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Behavioral</intervention_type>
    <intervention_name>Cooperative Work</intervention_name>
    <description>Nursing homes (NH)in the strong intervention group had two half-day meetings of cooperative work with a hospital geriatrician to identify NHs' weaknesses regarding quality of care and to establish strategies for overcoming these weaknesses.</description>
    <arm_group_label>strong intervention group (SIG)</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  Nursing homes (NH) voluntarily accepted to participate in the study.&#xD;
&#xD;
          -  NH residents of both sex&#xD;
&#xD;
          -  Residents living in the NH for ≥ 30 days&#xD;
&#xD;
          -  Residents and their general practitioner (GP) having received information about the&#xD;
             study&#xD;
&#xD;
          -  NH residents do not voluntarily decline to participate in the study&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  NH currently participating in another interventional study&#xD;
&#xD;
          -  GP of NH residents refused participation in the study.&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>N/A</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Yves Rolland, MD, PhD</last_name>
    <role>Principal Investigator</role>
    <affiliation>La Grave- Casselardit University Hospital Centre, Service de Médecine Interne et Gérontologie Clinique - Gérontopôle</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>EHPAD le parc ALBI</name>
      <address>
        <city>Albi</city>
        <zip>81000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Canarie Vieuzac</name>
      <address>
        <city>Argelès-Gazost</city>
        <zip>65400</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>MAPAD Les Pradels</name>
      <address>
        <city>Assier</city>
        <zip>46320</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Les Jardins auscitains</name>
      <address>
        <city>Auch</city>
        <zip>32000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Les jardins d´Agape</name>
      <address>
        <city>Auch</city>
        <zip>32000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Saint Dominique</name>
      <address>
        <city>Auch</city>
        <zip>32000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Résidence Mutualiste La Pyrénéenne</name>
      <address>
        <city>Aureilhan</city>
        <zip>65800</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Résidence Castelmouly</name>
      <address>
        <city>Bagnères-de-Bigorre</city>
        <zip>65200</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>ONAC résidence paul oddo</name>
      <address>
        <city>Barbazan</city>
        <zip>31510</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Korian Les Ainés du Lauragais</name>
      <address>
        <city>Baziège</city>
        <zip>31450</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Notre Dame</name>
      <address>
        <city>Beaumont-de-Lomagne</city>
        <zip>82500</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Ehpad Sherpa</name>
      <address>
        <city>Belmont-sur-Rance</city>
        <zip>12370</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Le Pastel</name>
      <address>
        <city>Bessières</city>
        <zip>31660</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Le Pastourel</name>
      <address>
        <city>Bessières</city>
        <zip>31660</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Sainte-Cécile</name>
      <address>
        <city>Bessières</city>
        <zip>31660</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Emeraude</name>
      <address>
        <city>Blagnac</city>
        <zip>31700</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Résidence de Vinci</name>
      <address>
        <city>Blagnac</city>
        <zip>31700</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD St joseph de BRASSAC</name>
      <address>
        <city>Brassac</city>
        <zip>81260</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Robert Durrieu</name>
      <address>
        <city>Bretenoux</city>
        <zip>46130</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>M.R Orpea</name>
      <address>
        <city>Cahors</city>
        <zip>46000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD La Cascade</name>
      <address>
        <city>Cajarc</city>
        <zip>46160</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Les Roses</name>
      <address>
        <city>Calmont</city>
        <zip>31560</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Gai Logis</name>
      <address>
        <city>Capdenac-Gare</city>
        <zip>12700</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD La Croix Bleue</name>
      <address>
        <city>Capdenac-gare</city>
        <zip>12700</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD le bosc Carmaux</name>
      <address>
        <city>Carmaux</city>
        <zip>81400</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Tour Tottier</name>
      <address>
        <city>Castelginest</city>
        <zip>31780</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>La Cerisaie</name>
      <address>
        <city>Castelmaurou</city>
        <zip>31180</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Notre Dame du Bon Accueil</name>
      <address>
        <city>Castelnau-d´Estrétefonds</city>
        <zip>31620</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>M.R St Luc - Castelnau Montratier</name>
      <address>
        <city>Castelnau-Montratier</city>
        <zip>46170</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Chic Ehpad C.H</name>
      <address>
        <city>Castelsarrasin</city>
        <zip>82100</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Villégiale Saint Jacques CHIC - CASTRES/MAZAMET</name>
      <address>
        <city>Castres</city>
        <zip>81100</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>MAPA Résidence St Astier</name>
      <address>
        <city>Catus</city>
        <zip>46150</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Caylus - Val de Bonnette</name>
      <address>
        <city>Caylus</city>
        <zip>82160</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Arc-En-Ciel</name>
      <address>
        <city>Cazals</city>
        <zip>46250</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Jeanne Penent</name>
      <address>
        <city>Cazères</city>
        <zip>31220</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>ALLIANCE</name>
      <address>
        <city>Cologne</city>
        <zip>32430</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD St Laurent</name>
      <address>
        <city>Cruejouls</city>
        <zip>12340</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Castelgirou</name>
      <address>
        <city>Cépet</city>
        <zip>31620</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD les arcades</name>
      <address>
        <city>Dourgne</city>
        <zip>81110</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Saint-Philippe</name>
      <address>
        <city>Ercé</city>
        <zip>09140</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Saint-Joseph</name>
      <address>
        <city>Fronton</city>
        <zip>31620</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD St ANDRE CH de Gaillac</name>
      <address>
        <city>Gaillac</city>
        <zip>81601</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD St JEAN CH de Gaillac</name>
      <address>
        <city>Gaillac</city>
        <zip>81601</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Accueil du Frère Jean</name>
      <address>
        <city>Galan</city>
        <zip>65330</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD La Baïse</name>
      <address>
        <city>Galan</city>
        <zip>65330</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Ch Gimont</name>
      <address>
        <city>Gimont</city>
        <zip>32200</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Foyer Pierre Bonhomme</name>
      <address>
        <city>Gramat</city>
        <zip>46500</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>MR Charles de Gaulle</name>
      <address>
        <city>Gramat</city>
        <zip>46500</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>MR Louis Conte</name>
      <address>
        <city>Gramat</city>
        <zip>46500</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Saint Dominique</name>
      <address>
        <city>Gramond</city>
        <zip>12160</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Ehpad de Graulhet</name>
      <address>
        <city>Graulhet</city>
        <zip>81300</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Saint-Jacques</name>
      <address>
        <city>Grenade</city>
        <zip>31330</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Ste Sophie</name>
      <address>
        <city>Grisolles</city>
        <zip>82170</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Résidence Zélia</name>
      <address>
        <city>Ibos</city>
        <zip>65420</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Le Jonquère</name>
      <address>
        <city>Juillan</city>
        <zip>65290</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Gustave Pédoya</name>
      <address>
        <city>La Bastide-de-Sérou</city>
        <zip>09240</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPADRouanet-Iché de LABASTIDE-ROUAIROUX</name>
      <address>
        <city>Labastide-Rouairoux</city>
        <zip>81270</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPADL'Oustal d'En Thibaud</name>
      <address>
        <city>Labruguière</city>
        <zip>81290</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>M.R La Miséricorde</name>
      <address>
        <city>Lacapelle-Marival</city>
        <zip>46120</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD St vinçent de paul</name>
      <address>
        <city>Lacaune</city>
        <zip>81230</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Résidence du Lac</name>
      <address>
        <city>Lafrançaise</city>
        <zip>82130</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD résidence le grand champ</name>
      <address>
        <city>Lagrave</city>
        <zip>81150</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Les Causeries</name>
      <address>
        <city>Laguépie</city>
        <zip>82250</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Centre hospitalier du Pays d´Olmes - Laroques d´Olmes</name>
      <address>
        <city>Laroques d´Olmes</city>
        <zip>09600</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>La Barbacane</name>
      <address>
        <city>Larrazet</city>
        <zip>82500</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>MAPAD Les Ségalines</name>
      <address>
        <city>Latronquière</city>
        <zip>46210</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Résidence Paul et Lisa</name>
      <address>
        <city>Launaguet</city>
        <zip>31140</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Ehpad Les Quietudes</name>
      <address>
        <city>Lautrec</city>
        <zip>81440</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Centre hospitalier du Pays d´Olmes - Résidence du Touyre</name>
      <address>
        <city>Lavelanet</city>
        <zip>09300</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>La Vendinelle</name>
      <address>
        <city>Le Cabanial</city>
        <zip>31460</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Ehpad Barrere</name>
      <address>
        <city>Lectoure</city>
        <zip>32700</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Ehpad Feral</name>
      <address>
        <city>Lectoure</city>
        <zip>32700</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD L´Oasis</name>
      <address>
        <city>Livinhac-le-Haut</city>
        <zip>12300</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD La Madone</name>
      <address>
        <city>Lourdes</city>
        <zip>65100</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Le Petit Jer</name>
      <address>
        <city>Lourdes</city>
        <zip>65100</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Notre Dame des Grâces</name>
      <address>
        <city>Lugan</city>
        <zip>12220</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Le Paginet</name>
      <address>
        <city>Lunac</city>
        <zip>12270</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>MAPAD Les logis de l´Impernal</name>
      <address>
        <city>Luzech</city>
        <zip>46140</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Le santoulis</name>
      <address>
        <city>Luzenac</city>
        <zip>09250</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Faux-Bourg Saint-Adrien</name>
      <address>
        <city>L´ Isle-en-Dodon</city>
        <zip>31230</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Saint-Jacques</name>
      <address>
        <city>L´ Isle-Jourdain</city>
        <zip>32600</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Résidence Curtis</name>
      <address>
        <city>Léguevin</city>
        <zip>31490</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Saint Joseph</name>
      <address>
        <city>Marcillac-Vallon</city>
        <zip>12330</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Val de Gers</name>
      <address>
        <city>Masseube</city>
        <zip>32140</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Le Clos du Raunier</name>
      <address>
        <city>Mazères</city>
        <zip>09270</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>MR Beau Séjour</name>
      <address>
        <city>Mercuès</city>
        <zip>46090</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD du CH Millau - St Michel</name>
      <address>
        <city>Millau</city>
        <zip>12100</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Les Charmettes</name>
      <address>
        <city>Millau</city>
        <zip>12100</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Louise de Roquelaure</name>
      <address>
        <city>Mirepoix</city>
        <zip>09500</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD de MONESTIES</name>
      <address>
        <city>Monestiés</city>
        <zip>81640</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Ange Gardien</name>
      <address>
        <city>Montauban</city>
        <zip>82000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Montauban - Ehpad Ushpa</name>
      <address>
        <city>Montauban</city>
        <zip>82000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>MR Saint Orens</name>
      <address>
        <city>Montauban</city>
        <zip>82000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>St Jean Marie Vianney</name>
      <address>
        <city>Montbeton</city>
        <zip>82290</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>MR Sainte-Marie</name>
      <address>
        <city>Montcuq</city>
        <zip>46800</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>M.R La Roseraie</name>
      <address>
        <city>Montfaucon</city>
        <zip>46240</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>MR L´Etoile du Soir</name>
      <address>
        <city>Montredon</city>
        <zip>46270</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>L´Hermitage</name>
      <address>
        <city>Montréjeau</city>
        <zip>31210</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Rés. Parc de la Corette</name>
      <address>
        <city>Mur-de-Barrez</city>
        <zip>12600</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Le Barry</name>
      <address>
        <city>Muret</city>
        <zip>31600</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Résidence Marie-Antoinette</name>
      <address>
        <city>Muret</city>
        <zip>31600</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Résidence les deux vallées</name>
      <address>
        <city>Nant</city>
        <zip>12230</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Sainte Marie les Ursulines</name>
      <address>
        <city>Nant</city>
        <zip>12230</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Résidence du Lac</name>
      <address>
        <city>Orleix</city>
        <zip>65800</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Centre Alzheimer Marie-Louise</name>
      <address>
        <city>Pechbonnieu</city>
        <zip>31140</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>La Houlette</name>
      <address>
        <city>Pibrac</city>
        <zip>31820</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>La Tranquilité</name>
      <address>
        <city>Pins-Justaret</city>
        <zip>31860</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Cité Saint Joseph</name>
      <address>
        <city>Plaisance du Gers</city>
        <zip>32160</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Le Prat</name>
      <address>
        <city>Plaisance-du-Touch</city>
        <zip>31830</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Oasis-Palmeraie</name>
      <address>
        <city>Pointis-de-Rivière</city>
        <zip>31210</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD La résidence du Lac</name>
      <address>
        <city>Pont de Salars</city>
        <zip>12290</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>L´Auta</name>
      <address>
        <city>Portet-sur-Garonne</city>
        <zip>31120</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Résidence du petit bois</name>
      <address>
        <city>Pradines</city>
        <zip>46090</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>M.R Les balcons du Lot</name>
      <address>
        <city>Prayssac</city>
        <zip>46220</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>M.R Les Lavandes</name>
      <address>
        <city>Puy-l´Évêque</city>
        <zip>46700</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD la Maison Du Lac</name>
      <address>
        <city>Puygouzon</city>
        <zip>81990</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Résidence Isatis</name>
      <address>
        <city>Quint-Fonsegrives</city>
        <zip>31120</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Hermitage et Terrasses de Rabastens</name>
      <address>
        <city>Rabastens</city>
        <zip>81800</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Jean Baptiste Delfau</name>
      <address>
        <city>Requista</city>
        <zip>12170</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD de Revel</name>
      <address>
        <city>Revel</city>
        <zip>31250</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Les Rosiers</name>
      <address>
        <city>Rignac</city>
        <zip>12390</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Bel Adour</name>
      <address>
        <city>Riscle</city>
        <zip>32400</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Bon Accueil</name>
      <address>
        <city>Rodez</city>
        <zip>12000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Julie Chauchard</name>
      <address>
        <city>Rodez</city>
        <zip>12000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Saint Cyrice</name>
      <address>
        <city>Rodez</city>
        <zip>12000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Saint Jacques du CH</name>
      <address>
        <city>Rodez</city>
        <zip>12000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Le clos de Siloe</name>
      <address>
        <city>Roquecourbe</city>
        <zip>81210</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD La Miséricorde</name>
      <address>
        <city>Saint-Affrique</city>
        <zip>12400</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Les Clos des Amandiers</name>
      <address>
        <city>Saint-Alban</city>
        <zip>31140</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Résidence de l´abbaye</name>
      <address>
        <city>Saint-Antonin-Noble-Val</city>
        <zip>82140</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Lavallée</name>
      <address>
        <city>Saint-Clar</city>
        <zip>32380</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Les Galets d´Olt</name>
      <address>
        <city>Saint-Côme-d´Olt</city>
        <zip>12500</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Le Mas Saint-Pierre</name>
      <address>
        <city>Saint-Gaudens</city>
        <zip>31800</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>L´Ensoleillade</name>
      <address>
        <city>Saint-Gaudens</city>
        <zip>31800</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD de l´Hôpital local</name>
      <address>
        <city>Saint-Geniez-d´Olt</city>
        <zip>12130</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Centre hospitalier Ariège Couserans</name>
      <address>
        <city>Saint-Girons</city>
        <zip>09201</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Le Val d´Olt</name>
      <address>
        <city>Saint-Laurent-d´Olt</city>
        <zip>12560</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Hector d´Ossun</name>
      <address>
        <city>Saint-Lizier</city>
        <zip>09190</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Les Rossignols</name>
      <address>
        <city>Saint-Lys</city>
        <zip>31470</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Maréchal Leclerc</name>
      <address>
        <city>Saint-Lys</city>
        <zip>31470</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Résidence La Joie de Vivre</name>
      <address>
        <city>Saint-Lys</city>
        <zip>31470</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Clos St François</name>
      <address>
        <city>Saint-Sernin-sur-Rance</city>
        <zip>12380</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Ehpad Chez Nous</name>
      <address>
        <city>Saint-Sulpice</city>
        <zip>81370</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Petite Plaisance SAVAGNAC</name>
      <address>
        <city>Salvagnac</city>
        <zip>81630</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Vert Coteau</name>
      <address>
        <city>Saverdun</city>
        <zip>09700</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Les grands chênes</name>
      <address>
        <city>Saïx</city>
        <zip>81710</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Paul Ané</name>
      <address>
        <city>Seix</city>
        <zip>09140</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>La Septfontoise</name>
      <address>
        <city>Septfonds</city>
        <zip>82240</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Ehpad Le Pre Fleuri</name>
      <address>
        <city>Serviès</city>
        <zip>81220</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Sainte Marie</name>
      <address>
        <city>Siradan</city>
        <zip>65370</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD St Vinçent et Ste Croix</name>
      <address>
        <city>Sorèze</city>
        <zip>81540</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD St Jean</name>
      <address>
        <city>St AMANS DES COTS</city>
        <zip>12460</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Les Tourelles</name>
      <address>
        <city>Toulouse</city>
        <zip>31000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Maurice Garrigou</name>
      <address>
        <city>Toulouse</city>
        <zip>31000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Plénitude Saint-Michel</name>
      <address>
        <city>Toulouse</city>
        <zip>31000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Résidence Saint-Simon</name>
      <address>
        <city>Toulouse</city>
        <zip>31035</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>La Cotonnière</name>
      <address>
        <city>Toulouse</city>
        <zip>31200</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Arc-en-Ciel</name>
      <address>
        <city>Toulouse</city>
        <zip>31300</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Les Fontaines</name>
      <address>
        <city>Toulouse</city>
        <zip>31300</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>La Pastellière</name>
      <address>
        <city>Toulouse</city>
        <zip>31300</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Orpéa Crampel</name>
      <address>
        <city>Toulouse</city>
        <zip>31400</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Caroline Baron</name>
      <address>
        <city>Toulouse</city>
        <zip>31500</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Le Grand Marquisat</name>
      <address>
        <city>Tournefeuille</city>
        <zip>31170</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Résidence Les Rives du Pélam</name>
      <address>
        <city>Trie-sur-Baïse</city>
        <zip>65220</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Ehpad Belcantou</name>
      <address>
        <city>Trébas</city>
        <zip>81340</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD du Centre Hospitalier Des Deux Rives</name>
      <address>
        <city>Valence D Agen</city>
        <zip>82400</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>M.R Résidence Valpré</name>
      <address>
        <city>Vayrac</city>
        <zip>46110</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD ND de Touscayrats</name>
      <address>
        <city>Verdalle</city>
        <zip>81110</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>MR Saint Jacques</name>
      <address>
        <city>Verdun-sur-Garonne</city>
        <zip>82600</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD La Clairière - Les Acacias</name>
      <address>
        <city>Vic-en-Bigorre</city>
        <zip>65500</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Ch Vic-Fezensac</name>
      <address>
        <city>Vic-fezensac</city>
        <zip>32190</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Le Château fleuri</name>
      <address>
        <city>Vic-Fezensac</city>
        <zip>32190</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Sainte Claire</name>
      <address>
        <city>Villefranche-de-Rouergue</city>
        <zip>12200</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>EHPAD Sud Rulhedu CH</name>
      <address>
        <city>Villefranche-de-Rouergue</city>
        <zip>12200</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Le Pin</name>
      <address>
        <city>Villeneuve-Tolosane</city>
        <zip>31270</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>France</country>
  </location_countries>
  <verification_date>July 2016</verification_date>
  <study_first_submitted>September 27, 2012</study_first_submitted>
  <study_first_submitted_qc>October 9, 2012</study_first_submitted_qc>
  <study_first_posted type="Estimate">October 10, 2012</study_first_posted>
  <last_update_submitted>July 18, 2016</last_update_submitted>
  <last_update_submitted_qc>July 18, 2016</last_update_submitted_qc>
  <last_update_posted type="Estimate">July 19, 2016</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>University Hospital, Toulouse</investigator_affiliation>
    <investigator_full_name>Yves Rolland</investigator_full_name>
    <investigator_title>MD PhD</investigator_title>
  </responsible_party>
  <keyword>Quality indicators</keyword>
  <keyword>quality of care</keyword>
  <keyword>nursing home</keyword>
  <keyword>long-term care unit</keyword>
  <keyword>nursing home organisation</keyword>
  <keyword>nursing home structure</keyword>
  <keyword>disability</keyword>
  <keyword>dependence</keyword>
  <keyword>functional decline</keyword>
  <keyword>functional impairment</keyword>
  <keyword>older adults</keyword>
  <keyword>elderly</keyword>
  <keyword>audit and feedback</keyword>
  <keyword>cooperative work</keyword>
  <keyword>geriatrician</keyword>
  <keyword>medication</keyword>
  <keyword>hospitalisation</keyword>
  <keyword>comorbidity</keyword>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT01703689
org study id: ARSMP.2010.1
nct id: NCT01703689
lead sponsor: 
collaborator: 
has dmc: No
Introduction: Efficacy of audit and feedback interventions on nursing home (NH)quality
      indicators is not well-established.

      The main objective: The main purpose of the IQUARE study was to examine the impact of two
      types of audit and feedback interventions on NH quality indicators and on residents
      dependence levels in a 18-month follow-up.

      Study hypothesis: We hypothesised that audit and feedback associated to educational and
      professional supportive interventions are more efficacy in improving NH quality indicators
      than audit and feedback only.

      Secondary objectives: Investigate the impact of the interventions on

        1. Residents:

             -  Functional decline rate

             -  Drug prescriptions (quantity and quality)

             -  Prevalence of adverse health outcomes (e.g., falls)

        2. NHs:

             -  Planning and implementation of therapeutic measures
IQUARE is a multicentric individually-tailored controlled trial comparing two types of audit
      and feedback interventions:

        -  audit and feedback associated to cooperative work meetings between hospital
           geriatricians and nursing home (NH) staff in a 6-month intervention (strong
           intervention)

        -  audit and feedback only (light intervention) Power statistics and sample size
           calculations indicated that each group should be composed of at least 2 500 individuals.
           The strong intervention will last 6 months and is composed of two face-to-face
           cooperative meetings (hospital geriatricians and NH staff). Data will be collected at
           baseline and in a 18-month follow-up.
allocation: Non-Randomized
intervention model: Parallel Assignment
primary purpose: Health Services Research
masking: Single (Outcomes Assessor)
measure: Change from baseline in nursing home quality indicators at 18 months
time frame: baseline and 18-month follow-up
description: Indicators of quality of care in 10 main outcomes: dementia (e.g.,prevalence of cognitive assessment), behavioural disturbances (e.g., prevalence of behavioural disturbances assessment), restraining (e.g., prevalence of restrained residents with a medical prescription for restraining), mood (e.g., prevalence of mood assessment), osteoporosis and falls (e.g., systematic analysis of fall records), nutrition (e.g., prevalence of residents who were weighed ≥ 3 times in the last 3 months), pressure ulcers (e.g., prevalence of residents who were evaluated for the risk of pressure ulcers), pain (e.g., prevalence of residents who were evaluated for pain among residents in end-of-life), medication (e.g., prevalence of re-evaluation of residents' drug prescriptions among residents who take psychotropic), and care and services (e.g., prevalence of hospitalisations in the emergency department in the last 12 months).
measure: Onset of dependence in activities of daily living from baseline to 18 months follow-up
time frame: baseline and 18-month follow-up
description: Onset of dependence will be measured using the 6-item Katz ADL scale. Activities examined are: bathing, dressing, transferring, walking inside home, incontinence, and eating/drinking. Ability in executing each activity will be set as: "able to execute alone, without difficulty", "able to execute alone, with some difficulty", or "needing help to execute or unable to execute".
measure: Reduction in the prescription of psychotropic drugs from baseline to 18-month follow-up
time frame: baseline and 18-month follow-up
description: It will be examined if the rate of antidepressants, anxiolytics, antipsychotics, and hypnotics/sedatives (coded according to the Anatomical Therapeutic Chemical classification. Information available at: http://www.whocc.no/atc_ddd_index/) prescriptions will be reduced between baseline and follow-up. A particular attention will be given to the prevalence of people taking 3 or more psychotropics (increased risk of drug-drug interaction and adverse drug reaction) and to the use of these medications among people with dementia.
arm group label: strong intervention group (SIG)
arm group type: Experimental
description: Nursing homes that received audit and feedback information on quality indicators and benefited of cooperative work meetings with hospital geriatricians
arm group label: intervention group (LIG)
arm group type: Active Comparator
description: Nursing homes that only received audit and feedback information on quality indicators
intervention type: Behavioral
intervention name: Audit and Feedback
description: Descriptive statistics to each nursing home (NH) with regards to its own indicators of quality and residents' health status, and the same descriptive statistics on the sub-regional and regional levels were done to all NHs for comparative purposes.
arm group label: intervention group (LIG)
arm group label: strong intervention group (SIG)
intervention type: Behavioral
intervention name: Cooperative Work
description: Nursing homes (NH)in the strong intervention group had two half-day meetings of cooperative work with a hospital geriatrician to identify NHs' weaknesses regarding quality of care and to establish strategies for overcoming these weaknesses.
arm group label: strong intervention group (SIG)
criteria: 
gender: All
minimum age: N/A
maximum age: N/A
healthy volunteers: No
last name: Yves Rolland, MD, PhD
role: Principal Investigator
affiliation: La Grave- Casselardit University Hospital Centre, Service de Médecine Interne et Gérontologie Clinique - Gérontopôle
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country: France
responsible party type: Principal Investigator
investigator affiliation: University Hospital, Toulouse
investigator full name: Yves Rolland
investigator title: MD PhD