Home-based Nurse Intervention in the Care of High Risk of Death Patients After Discharge From Geriatric Department
NCT Number: NCT06481917
Acronym: SAPHARI
Status: NOT_YET_RECRUITING
Study Type: INTERVENTIONAL
Phases: NA
Conditions: Health Services for the Aged|Advance Care Planning
Interventions: OTHER: Advance care plan|OTHER: Ergonomic analysis|OTHER: Evaluation of intervention acceptability
Sponsor: Lille Catholic University
Sex: ALL
Age: OLDER_ADULT
Enrollment: 104
Study Design: Allocation: RANDOMIZED|Intervention Model: PARALLEL|Masking: SINGLE (PARTICIPANT)|Primary Purpose: PREVENTION
Start Date: 2024-10
Completion Date: 2027-10
Locations: CHU d'Amiens, Amiens, 80054, France|CHU de Caen, Caen, 14033, France|CHU de Lille, Lille, 59000, France|Hôpital Saint Vincent de Paul (GHICL), Lille, 59000, France|Hôpital Saint-Philibert (GHICL), Lomme, 59160, France|CHU de Rouen, Rouen, 76000, France

Summary:
This study consists to evaluate the feasibility of a case-management intervention of Advance Care Plan (ACP) placement for elderly patients at high risk of death at twelve months discharged alive from acute geriatric medicine.

Feasibility will include the following indicators: rate of patients included and randomized, rate of patients remaining in the study, ACP rates achieved at one month.

Primary Outcome Measures: Rate of included patients, 12 months|Rate of patients remaining in the study, 12 months|Advance care planning rate achieved, 12 months
Secondary Outcome Measures: Rate of compliance to advance directives, Rate of compliance with the patient's advance directives one year after discharge from hospital; compliance to the the following situations will be identified:

* The patient is still alive: wishes to be re-hospitalized / does not wish to be re-hospitalized / has not made a decision.
* The patient is deceased: place of death specified: hospital, home or other / no decision taken., 12 months|Hospital Anxiety and Depression Scale (HADS) of caregivers and carers, Anxiety-depressive symptomatology of caregivers will be assessed using the Hospital Anxiety and Depression Scale (HADS) in the event of patient death, if this occurs within one year of discharge from hospital. The HAD scale is a screening instrument for anxiety and depressive disorders. It comprises 14 items rated from 0 to 3. Seven questions relate to anxiety (total A) and seven to depression (total D), giving two scores (maximum score for each = 21). To screen for anxiety and depressive symptoms, the following interpretation can be proposed for each of the scores (A and D) each of the scores (A and D):

* 7 or less: no symptoms
* 8 to 10: doubtful symptomatology - 11 or more: definite symptomatology., 12 months|Questionnaire to evaluate the acceptability of the intervention, The acceptability of the intervention will be assessed by a questionnaire after each home visit at 7 days and one month, with patients and caregivers in the intervention group., 12 months|EQ-5D-3L scale score, Changes in the quality of life of patients and caregivers one month after hospital discharge will be measured by changes in the EQ-5D-3L scale score. EQ-5D is a standardised measure of health-related quality of life.n EQ-5D-3L, the five dimensions each have three response levels of severity.

Respondents are asked to choose the statement in each dimension that best describes their health status on the day they are surveyed. Their responses are coded as a number (1, 2, or 3) that corresponds to the respective level of severity: 1 indicates no problems, 2 some problems, and 3 extreme problems. In this way, a person's health state profile can be defined by a 5-digit number, ranging from 11111 (having no problems in any of the dimensions) to 33333 (having extreme problems in all the dimensions)., 12 months