Evaluation of the Efficiency of the PRPP (Perceive, Recall, Plan and Perform) Task Analysis System on Support and Orientation Decisions for People With Aging Psychiatric Disorders (PATPV) Living in Independent Housing. (ECO2PSY)

Centre Hospitalier Charles Perrens, Bordeaux

Status: Enrolling

Conditions: Aging Disorder; Psychiatric Disorder; Mental Health

Treatments: Behavioral: Perceive, Recall, Plan and Perform (PRPP) evaluation

Study type: Interventional

Funder types: Other

Identifiers

NCT06738784

2024-A01961-46

Details and patient eligibility

About

Over the past 30 years, mental health policy has been geared towards increasing the number of people receiving care in the community, with a reduction of over 50% in the number of general psychiatric beds. The WHO recommends the implementation of alternatives to hospitalization, through the development of outpatient and home-based psychiatric care programs that support independent living.

People suffering from psychiatric disorders show cognitive decline as they age, including deficits in perception, attention, memory and problem-solving. These cognitive problems affect the ability to carry out the tasks of daily life, and make it more difficult to remain at home. In order to avoid hospitalization for these psychiatrically-stabilized patients who are losing their autonomy, it is necessary to take into account their mental and cognitive handicap, and to provide them with appropriate compensation.

Occupational therapy is a discipline concerned with the assessment, rehabilitation and integration of people with disabilities. Occupational therapists provide ecological assessments to support personalized care plans. The PRPP (Perceive, Recall, Plan and Perform) task analysis system is a validated, ecological tool that integrates an occupational therapy assessment and intervention model. The PRPP assessment measures occupational performance and the impact of cognitive impairments on information processing and on the cognitive strategies required to carry out activities. Research conducted in Canada illustrates the value of PRPP in supporting people with schizophrenia. To the best of our knowledge, no team has studied the use of PRPP in the decision-making process for maintaining people with aging psychiatric disorders (PATPV) at home.

Full description

The main hypothesis is that the use of the PRPP, through its scientific validity, will facilitate the decision-making of multi-professional care teams for the ambulatory support of PATPV to support :

• maintenance of independent housing
• or referral to a suitable place to live

This is a prospective, single-center study conducted within the "pathologies, handicap and aging" unit of the General and University Psychiatry (PGU) cluster at the Charles Perrens Hospital in Bordeaux.

The "pathologies, disability and aging" unit is dedicated to addressing the loss of autonomy and disability of people suffering from severe psychiatric disorders. One of its aims is to prevent hospitalization, particularly long-term hospitalization, for patients with chronic psychiatric pathologies who have become care-dependent. The program is structured around a multi-professional mobile team in charge of assessments, and a day hospital providing outpatient psychosocial rehabilitation care.

Enrollment: 66 estimated patients

Sex: All

Ages: 40 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Be at least 40 years old
• Reside within the PGU sector (Mérignac, Pessac, Talence and Gradignan)
• Receive support from the PGU - CHCP "pathologies, disability and aging" department.
• Fluency in French

Exclusion criteria

• Being hospitalized for more than 18 months
• Refuse inclusion in the research project

Trial design

Primary purpose: Supportive Care

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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66 participants in 1 patient group

PRPP Evaluation

Experimental group

Description:

T0 to T3 months: Evaluations * Multi-professional assessment by mobile team or day hospital * Completion of PRPP on 2 activities T3 months: First referral - Decision on the participant's future orientation following the PRPP T3 months to T9 months: Outpatient psychosocial rehabilitation (standard care) * Personalized psychosocial rehabilitation program determined in part by the PRPP and carried out in the day hospital for all participants. * PRPP interventions (occupational therapy) T9 months: Reassessment and confirmation of orientation * Second round of PRPP based on activities assessed at T3 months * Questionnaires to help with referral decisions, completed by the multi-professional teams involved in the program, and by the treating psychiatrist after the second PRPP has been completed.

Treatment:

Behavioral: Perceive, Recall, Plan and Perform (PRPP) evaluation