Clinical trial NCT01449968: Provision of a Mobile Geriatric Team Extra-Community Hospital
Official title: Provision of a Mobile Geriatric Team Extra-Community Hospital in Assessing and Regulating the Hospitalization of Frail Elderly Patients With Complex Medical and Social Situation
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Geriatric Disorder
Mobil Unit
Lead sponsor: University Hospital, Grenoble
Sponsor class: OTHER
First posted: 2011-10-10
Enrollment: 334
Sex: ALL
Minimum age (years): 75
Standard ages: OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: The study population includes patients over 75 years in medical condition or psycho-social complex, followed by a general practitioner to population centers include: Grenoble, Annecy and Roanne.

Brief summary: The purpose of this study is to demonstrate the effectiveness of the mobile unit to reduce the geriatric hospital inappropriate (especially for emergencies) to 1 month.

The primary endpoint: survival without hospitalization through the emergency inappropriate to 1 month.

Detailed description: The purpose of this study is to assess the effectiveness of the Mobile Geriatrics on the management of complex situations in retirement homes and in ambulatory care of frail elderly patients, reported by the generalist doctor, in terms of improving the conditions of use technical support hospital follow-up recommendations given by the mobile team and their impact on outcomes of care.

Eligibility criteria: Inclusion Criteria:

* Patient aged 75 and over living in complex medical or psycho-social complex or at risk of hospitalization
* Patient affiliated to social security or beneficiary of such a regime
* Patient available for follow-up to 6 months with a caregiver or accompanying social duly appointed.

Exclusion Criteria:

* Patient residing outside intervention sector
* Life-threatening emergency (ambulance)
* Lack of complexity of the situation, supported by routine care

Primary outcomes:
measure: effectiveness of the visit of the mobile unit to reduce the geriatric hospital inappropriate (especially for emergencies) to 1 month
timeFrame: 1 month
Secondary outcomes:
measure: follow-up rate of the proposals of UMG ext (adherence to recommendations and feasibility) and analyze the reasons for not monitoring these proposals one month
timeFrame: 1 month
measure: survival without hospitalization inappropriate, mortality, changes in functional status and cognitive health care consumption up to 6 months of surgery
timeFrame: 6 months
measure: effectiveness of the visit of the mobile geriatric home versus telephone follow-up of mobile geriatric unit
timeFrame: 6 months
measure: needs and difficulties of attending physicians in the care of frail elderly patients with complex medical and social situation before and after the establishment of mobile units for geriatrics.
timeFrame: 1 year
measure: cost effectiveness of two types of visit of the mobile unit of Geriatrics (telephone regulation and control over travel home phone)
timeFrame: 6 months
Other outcomes:
Locations:
city: Annecy
country: France
facility: CH Annecy
city: Grenoble
country: France
facility: University Hospital of Grenoble
city: Roanne
country: France
facility: CH Roanne
Study officials:
affiliation: Geriatric unit - University Hospital of Grenoble
name: Pascal COUTURIER, PUPH
role: PRINCIPAL_INVESTIGATOR
References:
citation: Bernabei R, Landi F, Gambassi G, Sgadari A, Zuccala G, Mor V, Rubenstein LZ, Carbonin P. Randomised trial of impact of model of integrated care and case management for older people living in the community. BMJ. 1998 May 2;316(7141):1348-51. doi: 10.1136/bmj.316.7141.1348.
citation: Stuck AE, Siu AL, Wieland GD, Adams J, Rubenstein LZ. Comprehensive geriatric assessment: a meta-analysis of controlled trials. Lancet. 1993 Oct 23;342(8878):1032-6. doi: 10.1016/0140-6736(93)92884-v.
citation: Elkan R, Kendrick D, Dewey M, Hewitt M, Robinson J, Blair M, Williams D, Brummell K. Effectiveness of home based support for older people: systematic review and meta-analysis. BMJ. 2001 Sep 29;323(7315):719-25. doi: 10.1136/bmj.323.7315.719.