(L-R) Ms Christine Brown and Prof Adrian Barnett
(L-R) Ms Christine Brown and Prof Adrian Barnett




A range of clinician, hospital and patient factors contribute to the provision of hospital treatments and care that may not always afford the best outcomes for older patients near the end of life. One-third of patients are estimated globally to receive non-beneficial treatment at the end of life. The InterACT study will evaluate whether raising doctor awareness of the risk profile of their older patients improves patient outcomes.



Ms Christine Brown 
Professor Adrian Barnett

Australian Centre for Health Services Innovation (AusHSI)
Centre for Healthcare Transformation, Queensland University of Technology (QUT), on behalf on the InterACT study team




The InterACT study is funded by a National Health and Medical Research Committee (NHMRC) Partnership grant to evaluate whether notifying clinicians when their older patients belong to an at-risk population for receiving non-beneficial care promotes care review and appropriate care pathways.  To identify patients who belong to the at-risk population, the InterACT study uses the ‘Criteria for Screening and Triaging to Appropriate aLternative care’ (CriSTAL) tool, which has shown predictive validity for short-term mortality in older patients, and the ‘Supportive and Palliative Care Indicators Tool’ (SPICT), which has been associated with one-year mortality.

Fourteen medical teams from three major Queensland public hospitals are participating in the study, which ends in June 2021. All patients aged 75 years or older who are admitted to one of the participating medical teams have their medical record screened by a trained nurse auditor using the CriSTAL and SPICT tools.  A notification is sent to the treating doctor of all patients deemed at-risk, which aims to trigger a clinical review and response. Agreed clinical responses include further review of each patient on the appropriateness of their current treatments and their wishes for future treatments.

The study will screen over 8,000 patients aged over 75 years with, so far, approximately 6,000 of these identified as at-risk. The study aims to discover if this screening and notification will improve patient outcomes, which include impact on length of hospital stay, intensive care unit admission and associated cost consequences. The aim is to provide better understanding of this patient cohort to inform future allocation of resources for frail older hospital patients.


Read the InterACT protocol paper here.

For more information visit: https://www.aushsi.org.au/research/aushsi-research-projects/the-interact-trial-intervention-for-appropriate-care-treatment/