Clinical trial NCT04016532: Personalized Dietary Advice After Discharge From Hospital in Geriatrics: Factors Associated With Improved Nutritional Status and Autonomy
Official title: Personalized Dietary Advice After Discharge From Hospital in Geriatrics: Factors Associated With Improved Nutritional Status and Autonomy
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Undernutrition of Elderly Peopole
Keywords: Elderly peopole
Undernutrition
Acute Geriatric
Lead sponsor: Gérond'if
Sponsor class: OTHER
First posted: 2019-07-11
Enrollment: 338
Sex: ALL
Minimum age (years): 60
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Primary purpose: OTHER

Brief summary: The purpose of this study is to identify the factors associated with the effectiveness of home dietary management in these elderly people returning home (personal home or independent residence) after hospitalization in acute geriatrics.

Detailed description: Patient recruitment will be carried out in the 6 participating hospital centres.

All patients willing to participate, will benefit from an Inclusion Visit (J0): Conducted in hospital in acute geriatric services before discharge from hospital. Verification of inclusion criteria, collection of patient consent by investigator, assignment of patient identification number, declaration of inclusion, and collection by investigator of inclusion data (age, sex, weight, height, appetite, dietary intake scale, risk factors for undernutrition by HAS, albumin, CRP, exit treatment, ADL, IADL and GIR, technical aids for walking, presence of professional and non-professional home workers).

Home visit J7 (30 min to 1 hour): initial dietary assessment, will be carried out between 24 hours and 7 days after discharge from hospital. During this visit, the dietician will perform several measurements (MNA-SF, weight, height, appetite assessment, ingest/24h Consumption of NOCs if prescribed in hospital, Quality of Life, ADL, IADL, acceptance of visit, follow-up of dietary advice and intercurrent medical events).

Home visit J30, J60 (30 min to 1h): Made by the dietician, during these visits will be carried out various measurements and questionnaires: Appetite assessment, weight, ingesta/24h, consumption of NOCs, acceptance of the visit, follow up on dietary advice, compendiums of intercurrent medical events.

Home visit J90 = Final visit. This visit is identical to the initial assessment (J7). Patients who are undernourished or at risk of undernutrition will receive an additional J15 home visit (15 days after discharge from hospital). This visit will be identical to visits J30, J60.

Eligibility criteria: Inclusion Criteria:

* Unscheduled hospitalization of at least 4 days in acute geriatrics,
* Direct return to home or independent residence after hospitalization,
* To be domiciled in the Hauts-de-Seine department,
* Good understanding of the French language,
* Beneficiary of a social security scheme,
* Having read the briefing note and having consented to participate in the study by signing a written consent,

Exclusion Criteria:

* Severe cognitive impairment according to DMS-IV criteria,
* Inflammatory syndrome (CRP \> 30 mg/l)
* Evolving cancer;
* Chronic respiratory failure,
* Stage IV heart failure
* long-term corticosteroids (\> 10 mg/d prednisolone or equivalent),
* Enteral and parenteral nutrition at home,
* Chronic end-stage pathology;
* Inability to walk without human help
* Major person subject to a legal protection measure (guardianship, guardianship and safeguarding of justice)

Primary outcomes:
measure: Screening for undernutrition in geriatric practice according the MNA-SF score (Short-Form Mini-Nutritional Assessment)
timeFrame: 3 months
Secondary outcomes:
measure: Assessment of the appetite according the VAS scale "Visual Analog Scale"
timeFrame: 3 months
measure: Assessment of teh degree of autonomy according AGGIR score
timeFrame: Inclusion (0 day)
measure: Assessment of patient's level of dependence through an appreciation of instrumental activities of daily living according Lawton scale
timeFrame: 3 months
measure: Assessment of the degree of patient dependence according "Index of Independence in Activities of Daily Living" KATZ scale
timeFrame: 3 months
measure: Grab force measurement according the dynamometer
timeFrame: 3 months
Other outcomes:
Locations:
city: Courbevoie
country: France
facility: Geriactric Departement, Rives de Seine hopsital
state: Ile-De-France
Study officials:
affiliation: Geriatric Departement, Rives de Seine hospital
name: Christine CHANSIAUX, MD
role: STUDY_CHAIR
References: