Elderly Clinical Trial
Official title:
A Descriptive Multicenter Investigation of Geriatrics Hotlines : Description of the Health Care Pathways and Conditions of Subjects Aged 75 and Over
In France, for general practitioners, the Emergency Hospitality Services (UAS) are the
fastest and usual way to respond to the complexity of managing elderly polypathological
patients. In 2013, the Regional Health Agencies proposed the creation of direct telephone
assistance managed by geriatric doctors (geriatric hotlines) to promote interactions city -
hospital. The aim of these hotlines is to improve the care pathways and health status of
seniors. The objective of this study is to describe the care trajectories and health status
of subjects over 75 years of age hospitalized in a short-term geriatric stay on the guidance
of a Geriatric Hotline.
The study will take place over 24 months and in 7 French University Hospitallers Centres. The
study will include all patients aged 75 and over, living at home or in an institution, who
are hospitalized in a short-term geriatric ward on the guidance of a Hotline.
The results will show whether a management by the geriatric hotline is the most suitable for
seniors, with an average length of stay probably shorter.
This is a multicenter descriptive study conducted in seven French investigating centers
(including university centers) with sub-group analysis. Participating establishments will all
be voluntary. In order to participate to the study, an establishment must have a specific
telephone line for doctor-doctor communications. Only calls originating from healthcare
professionals are to be taken into account.
The study will last for 24 months. Study population and eligibility The study population will
be constituted of people aged 75 and over, living in their own home or in a care facility
(including independent-living facilities), hospitalized in short-stay geriatric care referred
by the hotline in one of the investigating centers, and who are fully aware of the study and
their rights regarding their participation. The first questionnaire will be filled out via
the hotline by the geriatric specialist answering the call. A second questionnaire will then
be filled out during the patient's hospitalization by the treating geriatric specialist
Recruitment:
All people aged 75 years and over hospitalized in short-stay geriatric care via a hotline.
Inclusion:
Inclusion procedure: (the location, inclusion and non-inclusion criteria verification by
investigators, explanation of the study, and delivery of information form will all be the
responsibility of each center independently, conducted when the patient is admitted to
short-stay geriatric care).
Monitoring:
This study involves no extra examinations or treatment besides traditional practices, the
only difference being the digitization of all medical findings for analysis.
Study endpoint:
This corresponds to when the patient is discharged from short-stay geriatric care.
Study participation duration for each patient: short-stay geriatric care duration.
SELECTION AND EXCLUSION OF SUBJECTS FROM STUDY Inclusion criteria
- Age ≥75 years
- Male/Female
- Living in own home or in a care facility (including independent-living facilities)
- Hospitalized in short-stay geriatric care
- Confirmed receipt of information on the study and their rights, as stipulated by
articles L. 1122-1 of the French public health code, by 57 of the "Informatique et
Libertés" data protection act, and by MR-003 of the French data protection and civil
liberties authority (CNIL).
Non-inclusion criteria for people seeking participation
- Patients less than 75 years of age
- Refusal to participate
Procedure for early discontinuation of the study or exclusion from the study All subjects
can, at any moment and by any method, decide to withdraw from the study.
Evaluation criteria The primary endpoint is the mean duration of hospitalization in
short-stay geriatric care.
The secondary endpoints selected are hospital mortality rate, assessment of health status of
elderly patients hospitalized in short-stay geriatric wards using different criteria, and
their outcomes following discharge; describing and comparing how the different hotlines
across France function; analyzing the principal responses provided to doctors using the
hotline and improving awareness.
This study will be noninterventional. All interventions will be carried out following normal
clinical practices. There will be no unusual risk or specific constraint for participating
patients.
RECORDED VARIABLES AND SOURCE DATA The study data will be collected directly from the
questionnaires as the study progresses.
For the first questionnaire, filled out by the hotline geriatric specialist, the following
information will be collected for the study:
Health data: the identification of both speakers on the call; patient age; reasons for
calling; degree of emergency as perceived by the geriatric specialist and the calling doctor,
evaluated by simple verbal scale from 0 to 10; responses offered by geriatric specialist.
Administrative data: call duration in minutes. This questionnaire will be anonymous with no
identifying criteria. It will be filled out every time contact is made via the hotline,
irrespective of what responses are offered by the doctor (referrals to short-stay geriatric
care or not).
For the second questionnaire, filled out by the geriatric specialist treating the patient
during their hospitalization in short-stay geriatric care, following referral from the
hotline, the following information will be collected for the study:
Socio-demographic data: First and last name of the patient, Patient Permanent Identification
(PPI) number, patient age. This data will be anonymized on entry.
Health data: Reasons for hospitalization, number of hospitalizations during the year,
polypharmacy (>4), biological data : albumin and C-reactive protein levels for assessing
nutritional status, Charlson's index calculation using patient history for assessing the
comorbidities of our geriatric population), evaluation of activities of daily living (ADL)
prior to hospitalization according to the validated ADL (/6) and instrumental ADL (IADL)
scales (/4), evaluation of cognitive status using MMSE score (/30), recommended referral
after hospital discharge.
Family/Marital status data: single or with a partner, with or without children Living
situation data: Residence of patient (own home, independent-living facility, nursing home)
Type of living area data: urban, semi-urban or rural
Signaling data and findings relating to family or marital status will help characterize the
patients who participate.
Data relating to living location, type and area are recorded in order to assess the impact of
these factors on use of the hotline.
Finally, data relating to health status is recorded as justified by the bibliographical
references to which it is sent.
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