Implementation of a Personalised Health Plan (PHP) on Patient Quality of Life Score at 2-year Follow-up

Официальное название

Identifying and Managing Frailty in the Elderly in a Multiprofessional Health Home

Обзор

"Healthy ageing" is not limited to the absence of disease, but implies the "development and maintenance of the functional skills that enable the elderly to enjoy a state of well-being": (for example : the ability to walk, go out, engage in leisure activities, memorize...) It is interesting to study whether the implementation of a Personal Health Plan (PHP) in a Multiprofessional Health Home improves the quality of life of frail elderly people.

Подробное описание

"Healthy ageing" is not limited to the absence of disease, but implies the "development and maintenance of the functional skills that enable the elderly to enjoy a state of well-being": (for example : the ability to walk, go out, engage in leisure activities, memorize...) Between "good health" and "dependence", there is a precarious, reversible state of transition known as frailty. There are several simple tools for identifying frailty, such as the GFST (Gerontopole Frailty Screening Tool).

The Gerontopole Frailty Screening Tool and the Fatigue, Resistance, Ambulation, Illness, Loss of Weight questionnaire have proved more sensitive. The gold standard for diagnosing and assessing frailty is a comprehensive geriatric assessment based on the multidimensional model of the Standardized Geriatric Assessment (SGA). Its aim is to identify all the medical, functional, psychological and social problems that may affect a frail elderly patient, in order to set up a long-term follow-up project, taking into account the patient's needs.

It is interesting to study whether the implementation of a Personal Health Plan in a Multiprofessional Health Home improves the quality of life of frail elderly people.

Вмешательства

• Диагностический тест Quality of life test
  The results of the various quality-of-life scores used to compile the study statistics (ADL, iADL, MMS, GDS, MNA, EPICES, SPPB, SF-36) will be provided to the doctor, but without any specific comments or recommendations, and then presented to the patient. Number of emergency room visits and hospitalization days, drug untake evalautions and thepareutic compliance (GIRERD score) will be also collected.

Первичные конечные точки

• Evaluate the effect of implementing a personalized healthcare plan (PPS) on patient quality of life at M24 [Срок оценки: 2 years]

Вторичные конечные точки (11)

• Patient quality of life at M6 and M12 [Срок оценки: 1 year]
• Emergency room visits and hospitalizations at M6, M12 and M24 [Срок оценки: 2 years]
• Drug intake at M6, M12 and M24 [Срок оценки: 2 years]
• Therapeutic compliance at M6, M12 and M24 [Срок оценки: 2 years]
• Patient autonomy at M6, M12 and M24. [Срок оценки: 2 years]
• Falls and patient mobility at M6, M12 and M24 [Срок оценки: 2 years]
• Patient nutritional status at M6, M12 and M24 [Срок оценки: 2 years]
• Patient's cognitive status at M6, M12 and M24 [Срок оценки: 2 years]
• Patient's emotional state at M6, M12 and M24 [Срок оценки: 2 years]
• Patient's social fragility at M6, M12 and M24 [Срок оценки: 2 years]
• Patient autonomy at M6, M12 and M24. [Срок оценки: 2 years]

Критерии участия

Критерии включения

• Patient ≥ 70 years
• Autonomous patient (ADL ≥ 5)
• Patient identified as frail according to the Gérontopôle de Toulouse GFST grid
• Patient whose primary care physician is in the MSPs of Charleval or Romilly sur Andelle for the intervention group, and in the MSPs of Gaillon and Pont de l'Arche for the control group.
• Patient living at home or in an RPA
• Understanding of the French language
• Patient having read and understood the information letter and signed the consent form
• Affiliation with a social security scheme

Критерии исключения

• Hospital geriatric follow-up
• Geriatric assessment already carried out
• Person deprived of liberty by an administrative or judicial decision, or placed under court protection / sub-guardianship or curatorship
• History of illness or psychological or sensory abnormality likely to prevent the subject from fully understanding the conditions required for participation in the protocol, or from giving informed consent.

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Нерандомизированное

Модель

Параллельные группы

Маскирование

Открытое

Основная цель

Диагностика

Центры проведения

Франция · 4 центра

• Charleval — Charleval
• GAILLON — Gaillon
• Pont de L'Arche — Pont-de-l'Arche
• Romilly Sur Andelle — Romilly-sur-Andelle

Идентификаторы

NCT: NCT06560723 · 2022/0348/HP · 2023-A02358-37

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

Открыть это исследование на ClinicalTrials.gov ↗