Effectiveness and Organizational Conditions of Effectiveness of Telemedicine in Establishments Providing Care for the Dependent Elderly

Health Services for the Aged Clinical Trial

— EFFORT  

Official title:

Effectiveness and Organizational Conditions of Effectiveness of Telemedicine in Establishments Providing Care for the Dependent Elderly

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03486977
• Other study ID #: CHUBX 2016/32
• Status: Completed
• Start date: November 1, 2017
• Est. completion date: July 12, 2019

Study information

• Verified date: January 2020
• Source: University Hospital, Bordeaux
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

Study of interest of Telemedicine in establishments providing care for the dependent elderly (EHPAD in french) is a strategy for improving the course of care of residents, including the number not programmed hospitalizations, and a multidimensional analysis of the conditions of effectiveness of telemedicine will identify the keys to optimize its use.

Description:

The project combines quantitative and qualitative analyses :

1. Quantitative study

Study of comparative prospective cohort clustered in two parallel groups:

Group 'Telemedicine': establishments providing care for the dependent elderly (EHPAD in french) equipped for telemedicine (teleconsultation, casualty) as part of the regional project of the Aquitaine Regional Agency of Heath telemedicine device deployment.

Control group: Defined and equipped for telemedicine EHPAD after matching on the number of residents, the GMP (average weighted GIR : "Groupes Iso Ressources" = score to reflects the average level of dependency of residents of a residential care facility for the elderly), the PMP (weighted average PATHOS = an evaluation system set up by the National Union of Clinical Gerontology and the Medical Service of the National Fund for Health Insurance for Salaried Workers), the distance to a hospital with an emergency shelter service.

The rate of unscheduled hospitalizations will be collected during follow-up visits in clinical departments of the healthcare of the Gironde (french department) by a research staff.

2 Qualitative study In the Group of nursing homes with telemedicine, said group "Telemedicine", will be identified four long-term care facilities, selected according to their degree of use of telemedicine (ratio number of teleconsultation per month / number of beds) (EHPAD 2 strong users, 2 nursing homes) low users) within these four long-term care facilities will be carried out observations of field and in-depth interviews with professionals, managers and attending physicians.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 373
• Est. completion date: July 12, 2019
• Est. primary completion date: July 12, 2019
• Accepts healthy volunteers: No
• Gender: All
• Age group: 65 Years and older

Eligibility

Inclusion Criteria:

Quantitative research:

• All residents of nursing home men and women 65 years of age and more and likely to be eligible for a teleconsultation or a casualty because achieved one of the identified chronic pathologies as a reason for teleconsultation, will be included in both groups of long-term care

• Medical professionals working in the nursing home agreeing to answer the specifics questionnaires

Qualitative study:

• Doctors, physicians and coordinators nurses of Establishments Providing Care for the Dependent Elderly, nurses, orderly, psychologists, directors of Establishments

• Having a professional activity in nursing homes selected

• Having given their consent to participate in the study

Exclusion Criteria:

• Residents of long-term care facilities (quantitative study) Resident (or guardian/person) who expressed his opposition to participate in the study or not likely to be eligible for a teleconsultation or casualty Establishments Providing Care for the Dependent Elderly (qualitative) professionals

• Professional who expressed his opposition to participate in the study

Related Conditions & MeSH terms

• Health Services for the Aged

Intervention

Procedure:
• Evaluation of disease and follow-up
Correspondence medical consultation with specific device

Locations

Country	Name	City	State
France	EHPAD Le home medocain Arsac	Arsac
France	EHPAD Le parc du Bequet	Bègles
France	EHPAD Manon Cormier	Bègles
France	EHPAD Cos villa Pia	Bordeaux
France	EHPAD Grand Bon Pasteur	Bordeaux
France	EHPAD Henry Dunant	Bordeaux
France	EHPAD Le Clos Serena	Bordeaux
France	EHPAD Le Platane du Grand Parc	Bordeaux
France	EHPAD Residence Aime Cesaire	Bordeaux
France	EHPAD Résidence les Carmes	Bordeaux
France	EHPAD Seguin	Cestas
France	EHPAD résidence du Tertre	Fronsac
France	EHPAD Douceur de France	Gradignan
France	EHPAD Résidence l'Arousiney	Gujan-Mestras
France	EHPAD Le rétou	Lamarque
France	EHPAD Les coteaux	Lormont
France	Résidence de Médicis	Mérignac
France	EHPAD CHU Bordeaux	Pessac	Lormont
France	EHPAD Fontaudin	Pessac
France	EHPAD Villa presentine	Rauzan
France	EHPAD Jacqueline Auriol	Saint Seurin sur l'Isle
France	EHPAD Résidence La berge du lac	Talence
France	EHPAD Villa Bontemps	Talence
France	EHPAD Home Marie Curie	Villenave-d'Ornon

Sponsors (1)

Lead Sponsor	Collaborator
University Hospital, Bordeaux

Country where clinical trial is conducted

France, 

References & Publications (4)

Graverholt B, Forsetlund L, Jamtvedt G. Reducing hospital admissions from nursing homes: a systematic review. BMC Health Serv Res. 2014 Jan 24;14:36. doi: 10.1186/1472-6963-14-36. Review. — View Citation

Han JH, Morandi A, Ely EW, Callison C, Zhou C, Storrow AB, Dittus RS, Habermann R, Schnelle J. Delirium in the nursing home patients seen in the emergency department. J Am Geriatr Soc. 2009 May;57(5):889-94. doi: 10.1111/j.1532-5415.2009.02219.x. — View Citation

Morandi A, Han JH, Callison C, Ely EW, Schnelle JF. Delirium in nursing home residents across care transitions: a preliminary report. J Am Geriatr Soc. 2009 Oct;57(10):1956-8. doi: 10.1111/j.1532-5415.2009.02472.x. — View Citation

Vellas B. Integrating Frailty into Clinical Practice to Prevent the Risk of Dependency in the Elderly. Nestle Nutr Inst Workshop Ser. 2015;83:99-104. doi: 10.1159/000382092. Epub 2015 Oct 20. Review. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Number of hospitalization not programmed residents on Medicine Surgery obstetrics (MCO)	Number of hospitalizations not programmed residents on Medicine Surgery obstetrics (MCO) between the inclusion and 12 month	12 months
Secondary	the main diagnosis, coded by the International Classification of diseases for every hospitalization	Evaluate the number of inappropriate hospitalization. The inappropriate hospitalization will be performed using the classification of Weissman. Weissman classification identifies causes of potentially preventable hospitalizations, from the main diagnosis, coded by the International Classification of diseases, version 10 (ICD10).	12 months
Secondary	Score of the specific questionnaire for measurement of the context organizational and Managerial in health care facilities	Evaluate the impact of a strategy issued in EHPAD type teleconsultation or casualty on the quality of work life	12 months