Therapeutic Intervention Code in a Cognitive Geriatric Unit

Cognitive Impairment Clinical Trial

Official title:

Therapeutic Intervention Code in a Cognitive Geriatric Unit: Retrospective Analysis

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03408028
• Other study ID #: CHUB- status code
• Status: Completed
• Phase: N/A
• First received: January 17, 2018
• Last updated: January 17, 2018
• Start date: April 1, 2017
• Est. completion date: October 1, 2017

Study information

• Verified date: January 2018
• Source: Brugmann University Hospital
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

The diagnostic and therapeutic progresses, associated with modifications in lifestyle and socio-cultural level of populations, have led to a remarkable increase in life expectancy. At the same time, the increasing medicalization of the individual has eroded the traditional boundaries between health and illness, normal and pathological state. This leads to the patient losing his sense of ownership of his own death. If most patients died at home before the Second World War, 75% of the population dies in hospital or institution at the present date.

Most hospitals and care institutions have developed codes, in multidisciplinary internal consultation, to address the interruption or lack of implementation of treatments that make no sense from a medical point of vue. This avoids therapeutic relentlessness.The code in place within the CHU Brugmann is:

• code A: no therapeutic restriction

• code B: not to be resuscitated

• code C: not to be intensively treated (no escalation in therapeutic treatments)

• code D: best palliative care (progressive de-escalation in therapeutic treatments).

These codes are established in consultation with the patient or his legal representative and are re-evaluated in a multidisciplinary way every week.

Planning a care path and therefore establishing a therapeutic code is particularly important for people with cognitive impairment and dementia because the progressive loss of cognitive abilities complicates the process of decision making.

A large part of the admissions are made via the emergency department. For these patients, no therapeutic plan has been established beforehand. However, the perception of the functional and cognitive status of the patient directly influences the intensity of care provided. Cognitive disorders are a risk factor for the exclusion of access to palliative care for the elderly patient.

The objectives of this study are:

• To establish a record of the therapeutic limitation codes in an acute cognitive geriatric unit

• To correlate the therapeutic limitation code with the comorbidities of the patients

Recruitment information / eligibility

• Status: Completed
• Enrollment: 310
• Est. completion date: October 1, 2017
• Est. primary completion date: October 1, 2017
• Gender: All
• Age group: 65 Years and older

Eligibility

Inclusion Criteria:

Elderly patients with cognitive impairment admitted in the geriatric unit 83 within the CHU Brugmann between 01-01-2016 and 31-12-2016.

Exclusion Criteria:

Related Conditions & MeSH terms

• Cognitive Dysfunction
• Cognitive Impairment

Intervention

Other:
• Medical File consultation
Medical File consultation

Locations

Country	Name	City	State
Belgium	CHU Brugmann	Brussels

Sponsors (1)

Lead Sponsor	Collaborator
Murielle Surquin

Country where clinical trial is conducted

Belgium, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Therapeutic code	Therapeutic code	From 01-01-2016 till 31-12-2016
Primary	Cumulative Illness Rating Scale for Geriatrics	This scoring system measures the chronic medical illness ("morbidity") burden while taking into consideration the severity of chronic diseases in 14 items representing individual body systems. The cumulative final score can theoretically vary from 0 to 56.	From 01-01-2016 till 31-12-2016
Secondary	Age	Age	From 01-01-2016 till 31-12-2016
Secondary	Sex	Sex	From 01-01-2016 till 31-12-2016
Secondary	Ethnicity	Ethnicity	From 01-01-2016 till 31-12-2016