Trial reportJournal of the American Geriatrics Society2020
Hospital Elder Life Program in Long-Term Care (HELP-LTC): A Cluster Randomized Controlled Trial.
Trial report in Journal of the American Geriatrics Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Pooled it
- Pooled it
- Nursing home performance in a trial to reduce hospitalizations: Implications for future trials.Journal of the American Geriatrics Society · 2021Trial
- Understanding the Unique Ethical Challenges in Randomized Controlled Trials of Delirium Interventions for Older Adults: A Rapid Review.Anesthesia and analgesia · 2026Review
- Acute Deterioration in Long-Term Care: A Delphi Study of Indicators, Care Pathways and Implementation Strategies.International journal of nursing practice · 2026Article
- Review
- Improving delirium knowledge and recognition confidence in nursing homes through an e-learning program: a pre-post study.BMC medical education · 2026Article
- Prevalence, risk factors, and preventive interventions for delirium in older adults living at home and in residential care: a scoping review.BMC geriatrics · 2026Article
- Utility of the Charlson Comorbidity Index in the Preoperative Evaluation of Patients Undergoing Cardiac Surgery.Brazilian journal of cardiovascular surgery · 2026Article
- Better Assessment of Illness Study (BASIL) II for Delirium Severity: Study Design, Variables, and Methods.Journal of geriatric psychiatry and neurology · 2026Article
- Delirium in the long-term care: a challenge for clinicians and researchers-the negative outcomes related to delirium: a scoping review.European geriatric medicine · 2025Article
- Delirium in nursing homes and long-term care facilities: findings of a scoping review of detection tools.European geriatric medicine · 2025Article
- The etiology of delirium in long-term care settings: a Lernaean Hydra.European geriatric medicine · 2025Review
- Mobility Assessment Instruments.Seminars in oncology nursing · 2024Review
- Research progress in the hospitalization-associated disability among elderly patients.Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2023Article
- The Modified and Extended Hospital Elder Life Program: A remote model of care to expand delirium prevention.Journal of the American Geriatrics Society · 2023Article
- Efficacy of acute care pathways for older patients: a systematic review and meta-analysis.European journal of ageing · 2022Article
- Delirium in Nursing Home Residents: A Narrative Review.Healthcare (Basel, Switzerland) · 2022Review
- Comparative Implementation of a Brief App-Directed Protocol for Delirium Identification by Hospitalists, Nurses, and Nursing Assistants : A Cohort Study.Annals of internal medicine · 2022Article
- The PREvention Program for Alzheimer's RElated Delirium (PREPARED) cluster randomized trial: a study protocol.BMC geriatrics · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 1 country.
Funding
Abstract
BACKGROUND/
objectivesThe Hospital Elder Life Program (HELP) has been shown to prevent delirium in hospitalized older adults. The objective of this study was to test the efficacy of HELP adapted to long-term care (HELP-LTC).
designCluster randomized controlled trial.
settingA 514-bed academic urban nursing home.
participantsA total of 219 long-term nursing home residents who developed an acute illness or change in condition were randomly assigned to HELP-LTC (n = 105) or usual care (n = 114) by unit.
interventionHELP-LTC is a multicomponent intervention targeting delirium risk factors of cognitive impairment, immobility, dehydration, and malnutrition. Two certified nursing assistants (CNAs) delivered HELP-LTC components twice daily 7 days per week. In addition, recommendations were given to primary providers to reduce medications associated with delirium. MEASUREMENTS: Delirium (primary outcome) and delirium severity were ascertained each weekday by a research assistant blinded to group assignment, using the Confusion Assessment Method (CAM) and CAM severity score (CAM-S), respectively. Cognitive function was determined using the Cognitive Performance Scale (CPS). Hospitalization was ascertained by chart review.
resultsParticipants were 81.7 years of age on average and 65.3% female. At baseline, usual care group participants had better cognitive function than intervention group participants (CPS = 1.33 vs 2.25; P = .004). Delirium symptoms declined over the course of the episode (mean CAM-S = 3.63 at start vs 3.27 at end). Overall, 33.8% of the total sample experienced incident delirium. After adjusting for baseline cognitive function, no significant differences were found in delirium or delirium severity between intervention and usual care groups. Hospitalization was not significantly different between groups.
conclusionAn intervention targeting delirium risk in long-term nursing home residents did not prevent delirium or reduce delirium symptoms. Baseline differences in cognitive function between groups, greater than expected improvements in both groups, quality-enhancing practices such as consistent assignments delivered to both groups, and adaptations of the intervention may have biased results toward null. J Am Geriatr Soc 68:2329-2335, 2020.
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