Compared Efficacy of Nurse-led and GP-led Geriatric Assessment in PrImary Care (CEPIA)

Assistance Publique - Hôpitaux de Paris

Status: Completed

Conditions: Geriatric Assessment; Multimorbidity

Treatments: Other: health care organization

Study type: Interventional

Funder types: Other

Identifiers

NCT02664454

K140707

Details and patient eligibility

About

Older patients account for around 10% of the population, of which 57% have a long-term illness, and 33% were admitted in the past year.

Geriatric assessment (GA) is a multidimensional assessment of general health status that can help identifying deficiencies and followed by a personalized care plan.

Assessment and management of elderly patients is a daily concern for the general practitioner (GP) but conflicting results have been reported so far relating to the clinical impact of GA when applied in the primary care setting.

This study protocol aims to assess the effect on morbi-mortality of a complex intervention in patients aged ≥70 years with chronic conditions in primary care. It aims to demonstrate that a GA adapted to primary care, followed by a personalized care plan and combined with successful interprofessional collaboration can improve clinically relevant outcomes in elderly patients with chronic conditions such as one-year overall mortality, unplanned hospital admission, emergency visits, or institutionalization.

The CEPIA study will also help addressing the issue of whether an improved benefit could be achieved from a systematic nurse-led or a case-by-case GP-led GA.

Enrollment: 750 patients

Sex: All

Ages: 70+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients aged≥70 years with a long-term illness scheme or hospital admission the past 3 months
• Visiting their preferred general practioner (GP) or another GP in the same practice
• patient oral non opposition

Exclusion criteria

• Patient who does not speak French
• Severe disease with a life expectancy <12 months
• Institutionalized patients
• Patient insured under the French national health insurance system

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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750 participants in 3 patient groups

Systematic nurse-led GA

Experimental group

Description:

Interactive educational seminar for GPs and nurses, and focused on geriatric assessment in primary care combined with Systematic nurse-led GA and dedicated hotline for GPs seeking geriatric advice

Treatment:

Other: health care organization

GP-led GA on a case-by-case basis, as decided by the GP

Experimental group

Description:

Interactive educational seminar for GPs, and focused on Geriatric assessment in primary care combined with a GP-led GA on a case-by-case basis, as decided by the GP, and a dedicated hotline for GPs seeking geriatric advice

Treatment:

Other: health care organization

No intervention

No Intervention group

Description:

No educational seminar Usual care