Prevention of pneumonIA in Nursing hOme
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 3,818
- 试验地点
- 2
- 主要终点
- The comparison of the incidence of lung disease number between the two groups
研究概览
简要总结
Infections in nursing home are associated with high morbidity and mortality. Pulmonary infections are known to be the most problematic. In our INCUR observational study of 773 residents, 20.13% of residents had pneumonia during the year of follow-up. On average, the extra cost of pneumopathies was 4,467 euros / patient for the long-term care facility and 3,044 euros for the hospital.
详细描述
The pneumopathies in nursing home are the main cause of hospitalization of residents. Depending on the series, 9 to 50% of residents with pneumonia should be transferred. This reflects the difficulties faced by nursing home care teams in these situations. The respiratory symptomatology of nursing home residents is difficult to grasp and the prescribed antibiotic therapy is often considered inappropriate (25% to 75% of cases). Prevention of resident pneumonia, such as vaccination against pneumococcus remains poorly practiced, influenza vaccination teams or vitamin D supplementation.
In addition to the risk of mortality, lung diseases are often the cause of a rapid functional decline. Preventing pneumonia in nursing homes is therefore an important issue in the prevention of dependence, the quality of life, the health care system (use of hospitalization and transfer to emergencies) and health expenditure. In this vulnerable population, a prevention intervention seems particularly relevant.
In this research project, the investigators hypothesize that a multi-domain prevention intervention for pneumonia carried out by nursing teams in nursing homes can reduce the incidence of pneumonia. They also believe that this action would reduce emergency transfers and health expenditures.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- None
入排标准
- 年龄范围
- 60 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Living in a nursing home for at least 30 days at the start of inclusions,
- •Having received information concerning the study and having not expressed opposition to participate,
- •For which an agreement in principle of the attending physician has been obtained.
排除标准
- •Refusal of the resident (or of his legal representative) or of his treating physician after given information,
- •Resident at the end of life (life expectancy evaluated within one month by the coordinating physician),
- •Resident whose attending physician is already involved in the PIANO study under a resident of another nursing home.
结局指标
主要结局
The comparison of the incidence of lung disease number between the two groups
时间窗: 1 year
After the one-year : to compare of the incidence of lung disease between the two groups of Nursing home (the on-line formation/casual care) The diagnosis of pneumopathy will be defined on the criteria of the Infectious Risk Observatory in Geriatrics that are appropriate for nursing home residents, with at least two of the criteria defined for pneumonia
Number of Medical evidence of rattles or crepitates
时间窗: 1 year
Medical evidence of rattles or crepitates on chest auscultation : rattles or crepitates are criteria for the diagnosis of pneumopathy
次要结局
- Evaluating the incidence of all-cause hospitalizations(1 year)
- Evaluate the evolution of quality of care indicators in the nursing home(1 year)
- Establish a differential cost-effectiveness ratio at 1 year of the care of the residents in nursing home(1 year)
- Evaluation of the time spent by the health care team to support the patient between two groups(1 year)
- Functional decline of residents(1year)