Compared Efficacy of Nurse-led and GP-led Geriatric Assessment in PrImary Care
- Conditions
- Geriatric AssessmentMultimorbidity
- Interventions
- Other: health care organization
- Registration Number
- NCT02664454
- Lead Sponsor
- Assistance Publique - Hôpitaux de Paris
- Brief Summary
Older patients account for around 10% of the population, of which 57% have a long-term illness, and 33% were admitted in the past year.
Geriatric assessment (GA) is a multidimensional assessment of general health status that can help identifying deficiencies and followed by a personalized care plan.
Assessment and management of elderly patients is a daily concern for the general practitioner (GP) but conflicting results have been reported so far relating to the clinical impact of GA when applied in the primary care setting.
This study protocol aims to assess the effect on morbi-mortality of a complex intervention in patients aged ≥70 years with chronic conditions in primary care. It aims to demonstrate that a GA adapted to primary care, followed by a personalized care plan and combined with successful interprofessional collaboration can improve clinically relevant outcomes in elderly patients with chronic conditions such as one-year overall mortality, unplanned hospital admission, emergency visits, or institutionalization.
The CEPIA study will also help addressing the issue of whether an improved benefit could be achieved from a systematic nurse-led or a case-by-case GP-led GA.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 750
- Patients aged≥70 years with a long-term illness scheme or hospital admission the past 3 months
- Visiting their preferred general practioner (GP) or another GP in the same practice
- patient oral non opposition
- Patient who does not speak French
- Severe disease with a life expectancy <12 months
- Institutionalized patients
- Patient insured under the French national health insurance system
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Systematic nurse-led GA health care organization Interactive educational seminar for GPs and nurses, and focused on geriatric assessment in primary care combined with Systematic nurse-led GA and dedicated hotline for GPs seeking geriatric advice GP-led GA on a case-by-case basis, as decided by the GP health care organization Interactive educational seminar for GPs, and focused on Geriatric assessment in primary care combined with a GP-led GA on a case-by-case basis, as decided by the GP, and a dedicated hotline for GPs seeking geriatric advice
- Primary Outcome Measures
Name Time Method Primary composite endpoint combined with: - Percentage of all-cause mortality - Percentage of Unplanned hospital admission - Percentage of Emergency visits. - Percentage of Institutionalization At 12 months
- Secondary Outcome Measures
Name Time Method Percentage of Geriatric assessment performed Up to 12 months Percentage of personalized care plan performed Up to 12 months Number of medication prescription (polypharmacy) Up to 12 months Percentage of all-cause mortality At 12 months Percentage of Emergency visits At 12 months Quality of life (Duke profile score) At Day 0 and 12 months Autonomy by KATZ ALD score At Day 0 and 12 months Percentage of geriatric phone advices requested by GPs Up to 12 months Percentage of health care actions planned Up to 12 months Percentage of Unplanned hospital admission At 12 months Percentage of Institutionalization At 12 months Satisfaction of general practitioners and nurses after completion of intervention 12 months after the beginning of the study interview of general practionners and nurses by independant investigator
Percentage of satisfied general practitioner with the intervention 27months after the beginning of the study self-assessment
Trial Locations
- Locations (1)
Faculté de Médecine, Université Paris Est Créteil (UPEC)
🇫🇷Creteil, France