Follow-up of Elderly Patients in Ambulatory Surgery

Study Overview
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Brief Summary
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The number of surgical procedures performed in ambulatory hospitalization for cancers of the skin or breast is increasing for medical and economic reasons. But the protocols of care and the clinical pathways are poorly adapted for elderly patients with physical or cognitive impairment. The goal of this study is to test the impact of an oncology ambulatory surgical care in patients aged 75 years or older, with breast or skin cancer and treated in Henri Mondor hospital on the increase in the proportion of patients operated on an outpatient basis

Official Title
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Ambulatory Process of Elderly Patient for Skin and Breast Cancer Surgery

Conditions
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Breast Cancer, Skin Cancer, Surgery, Ambulatory

Intervention / Treatment
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* Other: Health care process with Nurse Navigator


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient ≥ 75 years old with breast cancer or skin cancer and requiring surgical excision: partial mastectomy, lumpectomy, axillary dissection, cutaneous excision, etc. With an indication of ambulatory care Patient (legal representative or trusted person or member of the family) having been informed and having given his non-oral objection to his participation in the study Possessing a health insurance Exclusion Criteria: Patients reserved for breast reconstruction to the operative gesture of tumor resection. Patients do not consent to care because of deficient mental state. Formal surgical contraindication due to a pathology medical device does not allow anesthesia. - Participation in another interventional research or be in the exclusion period after a previous search, if applicable

Ages Eligible for Study
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Minimum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Health care process with Nurse Navigator<br>A Nurse Navigator will: Be present at the announcement consultation Give information on the outpatient circuit Offer assistance for patients over 75 years Complete onco-geriatric orientation questionnaires Take care of patients on the ambulatory circuit | Other: Health care process with Nurse Navigator<br>* A Nurse Navigator will: Be present at the announcement consultation Give information on the outpatient circuit Offer assistance for patients over 75 years Complete onco-geriatric orientation questionnaires Take care of patients on the ambulatory circuit<br>|
| Health care process<br>Health care process | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of patients operated on an outpatient basis | Test the impact of an oncology ambulatory surgical care in patients aged 75 years or older, with breast or skin cancer and treated in Henri Mondor hospital | 3 month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of death | Test the impact of the new organization of care on the mortality | at Day 30 and Day 90 | 
| Number of patients converted to conventional care | Test the impact of the new organization of care on the proportion of patients converted to conventional care | at Day 30 and Day 90 | 
| Number of the passage to emergencies | Test the impact of the new organization of care on the passage to emergencies | at Day 30 and Day 90 | 
| Number of not programmed hospitalizations | Test the impact of the new organization of care on the not programmed hospitalizations | at Day 30 and Day 90 | 
| The autonomy Activities of Daily Living (ADL) | Test the impact of the new organization of care on the autonomy (ADL/IADL) | at Day 30 and Day 90 | 
| The autonomy Instrumental Activities of Daily Living (IADL) | Test the impact of the new organization of care on the autonomy (ADL/IADL) | at Day 30 and Day 90 | 
| Number of institutionalization to Long-term care and skilled nursing facilities | Test the impact of the new organization of care on the institutionalization to Long-term care and skilled nursing facilities | at Day 30 and Day 90 | 
| Number of passage to Long-term care and skilled nursing facilities | Test the impact of the new organization of care on the passage to Long-term care and skilled nursing facilities | at Day 30 and Day 90 | 
| Number of postoperative complications | Test the impact of the new organization of care on the postoperative complications | at Day 90 | 
| Costs of care | Test the impact of the new organization of care on the costs of care | at Day 30 and Day 90 | 
| Patients' satisfaction (questionnaire) for the prospective part of the study | Test the impact of the new organization of care on patients' satisfaction | at Day 30 and Day 90 | 
| Patient's quality of life (EQ50 questionnaire, for the prospective part of the study) | Test the impact of the new organization of care on quality of life (EQ50) (for the prospective part of the study) | at Day 30 and Day 90 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Breast Cancer, Skin cancer, Surgery, Ambulatory