Prevention of pneumonIA in Nursing hOme (PIANO)

Toulouse University Hospital

Status: Completed

Conditions: Pneumonia

Treatments: Other: Usual practice; Other: On-line training

Study type: Interventional

Funder types: Other

Identifiers

NCT04121182

RC31/17/0452

Details and patient eligibility

About

Infections in nursing home are associated with high morbidity and mortality. Pulmonary infections are known to be the most problematic. In our INCUR observational study of 773 residents, 20.13% of residents had pneumonia during the year of follow-up. On average, the extra cost of pneumopathies was 4,467 euros / patient for the long-term care facility and 3,044 euros for the hospital.

Full description

The pneumopathies in nursing home are the main cause of hospitalization of residents. Depending on the series, 9 to 50% of residents with pneumonia should be transferred. This reflects the difficulties faced by nursing home care teams in these situations. The respiratory symptomatology of nursing home residents is difficult to grasp and the prescribed antibiotic therapy is often considered inappropriate (25% to 75% of cases). Prevention of resident pneumonia, such as vaccination against pneumococcus remains poorly practiced, influenza vaccination teams or vitamin D supplementation.

In addition to the risk of mortality, lung diseases are often the cause of a rapid functional decline. Preventing pneumonia in nursing homes is therefore an important issue in the prevention of dependence, the quality of life, the health care system (use of hospitalization and transfer to emergencies) and health expenditure. In this vulnerable population, a prevention intervention seems particularly relevant.

In this research project, the investigators hypothesize that a multi-domain prevention intervention for pneumonia carried out by nursing teams in nursing homes can reduce the incidence of pneumonia. They also believe that this action would reduce emergency transfers and health expenditures.

Enrollment: 3,818 patients

Sex: All

Ages: 60+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Living in a nursing home for at least 30 days at the start of inclusions,
• Having received information concerning the study and having not expressed opposition to participate,
• For which an agreement in principle of the attending physician has been obtained.

Exclusion criteria

• Refusal of the resident (or of his legal representative) or of his treating physician after given information,
• Resident at the end of life (life expectancy evaluated within one month by the coordinating physician),
• Resident whose attending physician is already involved in the PIANO study under a resident of another nursing home.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

---

3,818 participants in 2 patient groups

Nursing home with On-line training

Experimental group

Description:

25 randomized residents will be included by nursing home Half of the institutions (randomized too) will benefit from an "on-line" training on the prevention and management of resident lung diseases

Treatment:

Other: On-line training

Nursing home with usual practice

Active Comparator group

Description:

This group of Institutions continue their usual practice (routine care) and will not benefit from training during the study period.

Treatment:

Other: Usual practice