Clinical trial NCT05788731: Become of Patients From the Permanent Access to Care (PASS) in Cayenne, French Guyana, Suffering From a Chronic Disease (High Blood Pressure - Diabetes) in the Common Law Schemes
Official title: Become of Patients From the Permanent Access to Care (PASS) in Cayenne, French Guyana, Suffering From a Chronic Disease (High Blood Pressure - Diabetes) in the Common Law Schemes
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Access to Health Services
Health Disparity, Minority and Vulnerable Populations
Chronic Disease
Social Security
Keywords: Health care system
Vulnerable Populations
Chronic Disease
social security
French Guiana
Lead sponsor: Centre Hospitalier de Cayenne
Sponsor class: OTHER
First posted: 2023-03-29
Enrollment: 120
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: CASE_ONLY
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: Majeur patients of the PASS of CH de Cayenne with a chronic disease

Brief summary: It is an observational research, conducted at the Cayenne hospital about the future of hypertensive and/or diabetic patients after their follow-up at the Permanent Access to care (PASS). The PASS is a medico-social structure that allows access to medical monitoring and support towards common law. The main objective of the study is to evaluate the use of the common law system by these patients. Then the goal is to study the relationship between integration into the system and socio-demographic, medical characteristics, and understanding of health monitoring. Data will be collected by guided telephone interviews and the review of medical records.

Detailed description: The problems of social inequalities in access to care are major public health issues as recalled by the Regional Health Agency (ARS) of French Guiana in the Regional Health Project (PRS). French Guiana has high precariousness indicators with half of its population living below the poverty line. In addition, health indicators are often more degraded in precarious populations. Thus, in French Guiana, there is a higher rate of premature mortality, partly attributable to obesity, sedentary lifestyle, diabetes and hypertension than in mainland France. Despite an increased need for follow-up of chronic pathologies, the precarious population faces many difficulties in accessing care. The Permanent Access to Health Care (PASS) in Cayenne is a medico-social system, created to respond to these problems. The PASS allows access to monitoring of chronic diseases and support towards the common law healthcare system. Although the phenomenon of non-use of care studied in the precarious population of western French Guiana seems primarily attributable to the absence of social security. The main objective is to evaluate the use of the common law system in hypertensive or diabetic patients treated at the PASS in Cayenne. In addition, the investigators want to study the relationship between integration into the system and the socio-demographic, medical characteristics, understanding of health monitoring.

Eligibility criteria: Inclusion Criteria:

* Be 18 years or older
* Past follow-up by the PASS of the Cayenne hospital for at least one chronic pathology identified as follows: hypertension, diabetes.
* The discharge and reorientation to general practitioner have happened between 1 month and 1 year prior to this study.

Exclusion Criteria:

* Patient with a psychiatric condition
* Refusing the study

Primary outcomes:
measure: The proportion of patients integrating the common law system
timeFrame: during inclusion
Secondary outcomes:
measure: Study the relationship between system integration and socio-demographic, understanding characteristics
timeFrame: during inclusion
measure: Study the relationship between system integration and medical, health follow-up
timeFrame: during inclusion
measure: Proportion of patients resorting to one or more consultations with a general practitioner.
timeFrame: during inclusion
Other outcomes:
Locations:
city: Cayenne
country: French Guiana
facility: Centre Hospitalier de Cayenne
Study officials:
References:
citation: Rochemont DR, Lemenager P, Franck Y, Farhasmane A, Sabbah N, Nacher M. The epidemiology of acute coronary syndromes in French Guiana. Ann Cardiol Angeiol (Paris). 2021 Feb;70(1):7-12. doi: 10.1016/j.ancard.2020.09.032. Epub 2020 Oct 14.