Telemedicine - Evaluation of the Impact of a Telemedicine Device (DTM) on the Prevention of Emergency Department Visits and Hospitalizations of Nursing Home Residents Aged Polypathological

NCT04008472 | Completed

• 1 other identifier: I14036 - GERONTACCESS
• Study Type: interventional
• Target: 428
• Locations: 0 countries
• Sites: N/A

Brief Summary

For several decades, there is an aging population, particularly in industrialized countries. This lengthening of the duration of life is accompanied by an increase in the number of chronically ill patients. On an estimate of 15 million patients in France today, the figure reported for 2020 would be 20 million patients. Chronic diseases are responsible for functional decompensation and admission responsible autonomy breaks in nursing homes (Accommodation Establishment of People Dependent Elderly). An estimated 700,000 the number of people currently living in retirement homes in France. These residents are mostly dependent and multiple pathologies requiring regular general and specialist medical monitoring . Medical concern demographic outlook and the need for access to quality care across the country leads to the development of telemedicine. The need for telemedicine is not the same throughout the territory. It is less, or different, in highly urbanized areas where the density of health professionals is high, then it can be a new response to the needs of rural, isolated or landlocked. Telemedicine promotes the development of the concept of graduated care sector, especially in the management of patients with chronic diseases. Telemedicine in rural nursing homes and can be a tool for assessing, monitoring and coordination to avoid decompensation of chronic conditions and rehospitalization. This organization can afford to break the isolation of general practitioners and EHPAD coordinators physicians in rural areas and provide access to several specialties.

Conditions

Polypathology

Keywords

Telemedecine

Outcome Measures

Primary Outcomes (1)

• Evaluation of telemedicine on prevention in old and polypathological patients

  Proportion of patients with emergency admission or unscheduled hospitalization in medical or surgical service over 12 months.

  After 12 months

Secondary Outcomes (5)

• Medico-economic impact

  After 12 months

• Impact on recurring hospitalizations

  After 12 months

• Impact on overall health

  After 12 months

• Impact on the quality of life ( EQ5D questionnary)

  After 12 months

• Impact on mortality

  After 12 months

Study Arms (2)

Telemedecine

EXPERIMENTAL

Patients benefiting from telemedicine

Other: Telemedecine

Control

NO INTERVENTION

routine care without telemedecine

Interventions

Telemedecine OTHER

Initiation of tele-medical consultation with the resident, a caregiver for the nursing home, the referring physician and geriatrician téléexpert. After a overall geriatric assessment in nursing homes by UPSAV the first teleconsultation is organized within 10 days. Subsequent visits are scheduled every 3 months for 12 months. Spontaneous visits can be requested at the initiative of the referring physician.

Telemedecine

Eligibility Criteria

• Age: 60 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Resident in one of 9 nursing homes participating in the project
• Resident polypathologique has at least two comorbidities
• Having given free consent, informed writing and signed by himself and / or his legal representative

You may not qualify if:

• Unaffiliated resident or non-receiving of social security
• severe pathology (ies) involving life-threatening in the short term
• Resident whose return home, transfer to another nursing home or to a long term care unit is programmed

Sponsors & Collaborators

• University Hospital, Limoges: lead

Study Officials

• Achille TCHALLA, Professor

  University Hospital, Limoges

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 2, 2019
• First Posted: July 5, 2019
• Study Start: November 1, 2015
• Primary Completion: January 1, 2018
• Study Completion: May 1, 2019
• Last Updated: August 9, 2019

Record last verified: 2019-07