Impact of Systematic Tracking of Dementia Cases on the Rate of Hospitalization in Emergency Care Units
- Conditions
- Dementia in Nursing Home
- Interventions
- Other: MultiDisciplinary Team Meetings (MDTM)
- Registration Number
- NCT01569997
- Lead Sponsor
- University Hospital, Toulouse
- Brief Summary
Introduction: Epidemiological data show that in France only half of patients with Alzheimer disease are currently diagnosed in the general population. The absence of early diagnosis of dementia reduces the opportunities of patients to receive optimal care. One of the consequences of undiagnosed dementia is inadequate use of emergency care units.
The main objective: The main aim of this study is to evaluate the impact of a systematic case-finding procedure of dementia cases in nursing homes through a MDTM on the rate of hospitalization in emergency care units.
Secondary objectives:
To assess the impact of systematic tracking of dementia cases on the:
* Quantity and quality of drug-prescription
* Appropriateness of hospitalizations
* Prevalence of neuropsychiatric symptoms
* Dependency
* Quality of life
* Burden of nursing staff working conditions
* Planning of specific therapeutic measures
* Overall health care costs
- Detailed Description
This is a multicentre, cluster randomized study comparing two parallel groups:
* Intervention group: nursing homes whose residents benefit from MDTM to identify the cases of dementia and to propose an adequate care project
* Control group: nursing homes whose residents continue to benefit from usual care In each group, 1000 elderly subjects aged over 60 years without documented diagnosis of dementia will be included and monitored for a period of 18 months.
Information about the main and secondary aims will be collected monthly through online questionnaires.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 1428
-
Residents of both sex, aged 60 years or over
-
Residents living in a nursing home participating in the study
-
Residents living in the nursing home for 30 days or more
-
Residents without diagnosed and documented dementia, identified as follows:
- residents not identified by the French Healthcare system as suffering from dementia (ALD 15)
- residents not benefiting from a specific care program or a specialized follow-up for dementia
- residents for whom there is no appropriate investigation for dementia diagnosis in medical records
- residents not taking specific drugs for dementia (Cholinesterase inhibitors and/or Memantine)
-
Residents and their GP having received information about the study
-
Residents and their GP having expressed their agreement to participate in the study
-
Residents aged less than 60 years
-
Residents not living in a nursing home participating in study
-
Residents living in nursing home for less than 30 days
-
Residents with diagnosed and documented dementia, identified as follows:
- residents Identified by the French Healthcare system as suffering from dementia (ALD 15)
- residents benefiting from specific care programme or specialized follow-up for dementia
- residents for whom there is appropriate investigation for dementia diagnosis in medical records
- residents taking specific drugs for dementia (Cholinesterase inhibitors and/or Memantine)
-
Residents and/or their GP who received no information about the study
-
Residents and/or their GP having expressed their opposition to participate in the study
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Intervention group MultiDisciplinary Team Meetings (MDTM) Intervention group: nursing homes whose residents benefit from MDTM to identify the cases of dementia and to propose an adequate care project
- Primary Outcome Measures
Name Time Method Incidence of hospitalizations in emergency care units 18 months Monthly collection during follow-up (18 months)
- Secondary Outcome Measures
Name Time Method Prevalence of antipsychotic prescription Baseline visit, 4 months, 18 months Incidence of inappropriate hospitalizations 18 months Monthly collection during follow-up (18 months)
Prevalence of neuropsychiatric symptoms evaluated by NPI-nursing staff version Baseline visit, 18 months Dependency evaluated by AGGIR and IADL-4 items Baseline visit, 18 months Quality of life evaluated by QOL-AD Baseline visit, 18 months Number of nursing staff's time off work 18 months Monthly collection during follow-up (18 months)
Number of days off work by nursing staff 18 months Monthly collection during follow-up (18 months)
Presence of advanced care planning in patients medical records Baseline visit, 18 months Advanced care planning will be checked through behavioural disosders, transfer to hospital intensive care and resuscitation
Overall healthcare costs 18 months Monthly collection during follow-up (18 months)
Trial Locations
- Locations (90)
Ehpad Maison de Retraite Louise Anceau
🇫🇷Albi, France
Ehpad Mr "Les Jardins de Jouvence"
🇫🇷Albi, France
Mapad La Renaudie Ch Albi
🇫🇷Albi, France
Ehpad Maison de Retraite Olga Ducoudray
🇫🇷Albi, France
Ehpad Maison de Retraite Hl Ax Les Thermes
🇫🇷Ax-les-Thermes, France
Ehpad Les Ajoncs D'Or
🇫🇷Allaire, France
Ehpad Residence Ker-Heol
🇫🇷Brest, France
Ehpad Marie Lehman
🇫🇷Balma, France
Ehpad Residence Saint Astier
🇫🇷Catus, France
Mapa de L'Hopital Local de Caussade
🇫🇷Caussade, France
Ehpad Themis Lasplanes
🇫🇷Colomiers, France
EHPAD Résidence Castelgirou
🇫🇷Cepet, France
Ehpad Maison de Retraite Ste Marthe
🇫🇷Ceignac, France
Ehpad Leon Ronzier Joly
🇫🇷Clermont L'herault, France
Ehpad Maison de Retraite Joseph Sauvy
🇫🇷ERR, France
Ehpad Mr Bellissen Chi Du Val D'Ariege
🇫🇷Foix, France
Ehpad Residence Borde Haute Promo-Accueil
🇫🇷Escalquens, France
Ehpad Hopital Local Fleurance
🇫🇷Fleurance, France
Mapad "Firmi"
🇫🇷Firmi, France
Ehpad Dr Robert
🇫🇷Guer, France
Ehpad Residence Grand'Maison
🇫🇷L'union, France
Ehpad Residence Provencale Medicafrance
🇫🇷La Roquebrussanne, France
Ehpad Residence Clairefontaine
🇫🇷Lamorlaye, France
Mapad Ch Lavaur
🇫🇷Lavaur, France
Ehpad Residence D'Automne de La Ferme
🇫🇷Le Mee Sur Seine, France
Ehpad Maison de Retraite "Les Charmilles"
🇫🇷Lescure d'Albigeois, France
Residence Le Parc
🇫🇷Lezat Sur Leze, France
Ehpad Mr Lagrange
🇫🇷Lisle Sur Tarn, France
Ehpad Emile Dubois
🇫🇷Marchiennes, France
AP-HM Hôptal La Timone Service de Pédiatrie Mutidisciplinaire
🇫🇷Marseille, France
Ehpad Et. Public Gerontologie de Marines
🇫🇷Marines, France
Ehpad Les Mille Soleils
🇫🇷Marciac, France
Ehpad Maison Retraite Hl Mauvezin
🇫🇷Mauvezin, France
Ehpad Maison de Retraite Saint Joseph
🇫🇷Mazamet, France
Ehpad-Maison Retraite Hl Mirande
🇫🇷Mirande, France
Ehpad Les Noisetiers
🇫🇷Nice, France
Ehpad Fondation Pauliani
🇫🇷Nice, France
Ehpad Mais de Retraite Saint-Joseph
🇫🇷Ossun, France
Ehpad Mr Bariol Chi Du Val D'Ariege
🇫🇷Pamiers, France
Ehpad Residence Ancilla
🇫🇷Nice, France
Ehpad Residence Le Parc
🇫🇷Panazol, France
AP-HP Hôpital Necker Enfants Malades Service d'endocrinologie pédiatrique - 149 route de Sèvres
🇫🇷Paris, France
Ehpad Furtado Heine
🇫🇷Paris, France
Ehpad Julie Siegfried
🇫🇷Paris, France
Ehpad La Pirandelle
🇫🇷Paris, France
Ehpad Residence Anselme
🇫🇷Paris, France
Ehpad Residence Herold
🇫🇷Paris, France
Ehpad L'Oree Du Bois
🇫🇷Rieux Volvestre, France
Ehpad Residence Saint-Amans
🇫🇷Rodez, France
Ehpad Residence Themis La Joie de Vivre
🇫🇷Saint Lys, France
Ehpad A Labouilhe
🇫🇷Saint Orens de Gameville, France
Ehpad Public de Saint-Remy de Provence
🇫🇷Saint Remy de Provence, France
Ehpad Genevriers
🇫🇷St Martory, France
Ehpad Maison de Retraite Chic Tarbes Vic
🇫🇷Tarbes, France
Ehpad Sainte Anne
🇫🇷Tinteniac, France
Ehpad de La Cote Pavee
🇫🇷Toulouse, France
Ehpad Mr Henri Iv
🇫🇷Toulouse, France
Ehpad Residence Saint-Simon
🇫🇷Toulouse, France
Usld Domaine de La Cadene
🇫🇷Toulouse, France
Ehpad Maison de Retraite Privee de Mazeres
🇫🇷Mazeres, France
Ehpad Kerdigemer
🇫🇷Brest, France
Ehpad Saint Reah Hir
🇫🇷Le Conquet, France
Ehpad La Cheneraie
🇫🇷Lherm, France
Mapad Labastide Ch Lourdes
🇫🇷Lourdes, France
Ehpad Era Caso
🇫🇷Montauban de Luchon, France
Centre de Gerontologie Pompeyrie Chu Agen
🇫🇷Agen, France
Ehpad L'Acacia
🇫🇷Nailloux, France
Ehpad Maison de Retraite Sainte Agnes
🇫🇷Montredon Labessonnie, France
Ehpad Chis Castelsarrasin-Moissac
🇫🇷Moissac, France
Ehpad Ma Maison
🇫🇷Montpellier, France
Ehpad Maison Retraite Ch Montauban
🇫🇷Montauban, France
Ehpad Residence Adeline
🇫🇷Pierre Buffiere, France
Ehpad Residence Belleville
🇫🇷Paris, France
Ehpad Residence D'Automne Medica-France
🇫🇷Reims, France
Ehpad Residence Oceane
🇫🇷Paris, France
Ehpad Tiers Temps Paris
🇫🇷Paris, France
Ehpad Le Jardin Des Loges
🇫🇷Saint Bonnet, France
Ehpad Les Bruyeres
🇫🇷Sousceyrac, France
Ehpad Maison Retraite Orelia Ch St Gaudens
🇫🇷St Gaudens, France
Ehpad Residence "Le Doyenne Du Carmel"
🇫🇷Tarbes, France
Ehpad Umt
🇫🇷Valence-d'albigeois, France
Ehpad Maisonneuve
🇫🇷Villefranche de Lauragais, France
Ehpad Saint-Jacques
🇫🇷Villemur Sur Tarn, France
Ehpad Gaubert
🇫🇷Toulouse, France
Ehpad Pierre Ducis
🇫🇷Toulouse, France
Ehpad Residence La Cotonniere
🇫🇷Toulouse, France
Ehpad Residence Le Clos Des Carmes
🇫🇷Toulouse, France
Ehpad Residence Marguerite
🇫🇷Toulouse, France
Logements Foyer La Fontanelle
🇫🇷Naucelle, France
Ehpad L'Ecrin Des Sages
🇫🇷Mèze, France