Risk Factors for Falls After Intervention of the Urgent Medical Assistance Service (SAMU) in the Elderly Person at Home (RISING-DOM)

Toulouse University Hospital

Status: Completed

Conditions: Elderly

Treatments: Other: Usual care; Other: Proposal for a personalized intervention plan (PIP); Other: standardized gerontological evaluation (EGS); Other: Follow-up

Study type: Interventional

Funder types: Other

Identifiers

NCT04132544

RC31/17/0453

Details and patient eligibility

About

In this project, the investigators are interested in a particular population, that of elderly subjects who used the SAMU after a fall and who are not hospitalized or are hospitalized less than 24 hours. The scientific literature concerning this population is poor . However, this is a particularly vulnerable population. The Direction of research, studies, evaluation and statistics (DREES) report notes that in 2005 in metropolitan France, 24% of people aged 65 to 75 said they had fallen in the last 12 months. Home falls among seniors may require emergency medical services (EMS).

Full description

The first cause of accidental death in people over 65, the fall often has a pejorative impact on the physical, psychological and quality of life . It is also predictive of entry into an institution.

In this project, the investigators propose to evaluate the patient at home with a Gerontological Assessment Nurse working in collaboration with the attending physician, whenever the fall triggers a call to the SAMU (without hospitalization or with hospitalization of less than 24 hours). In addition to the evaluation, the nurse will propose a personalized intervention plan (PIP) based on targeted and prioritized actions.

The Main objective is to study the effect of a personalized intervention plan (PIP) proposed by a Gerontological Assessment Nurse at home in the elderly who used the SAMU for a fall (with on-site care or hospitalization inferior to 24h), on the delay institutionalization or death before institutionalization compared to standard care.

Enrollment: 952 patients

Sex: All

Ages: 70+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Living at home
• Living at maximum 45 minutes from a hospital center participating in the study (for logistical reasons and practices of study organization)
• Intervention of the SAMU for a fall at home without there being hospitalization or with hospitalization lasting less than 24h
• Patient or trusted person capable of giving telephone information
• Patient or his / her trusted person who has agreed to participate in the study
• Patient affiliated to a social security scheme

Exclusion criteria

• Total dependency (ADL at 0)
• Entry in nursing home already scheduled within 3 months

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

---

952 participants in 2 patient groups

Intervention group

Experimental group

Description:

* a standardized gerontological evaluation (EGS) and a fall balance performed at home or teleconsultation by a Gerontological Assessment Nurse * the proposal for a Proposal for a personalized intervention plan (PIP) to correct potentially reversible and modifiable factors * a close follow-up by the Gerontological Assessment Nurse for the implementation of the PIP throughout the follow-up period of 24 months (6 home visits and 5 telephone follow-ups).

Treatment:

Other: Follow-up

Other: standardized gerontological evaluation (EGS)

Other: Proposal for a personalized intervention plan (PIP)

Comparison group - usual care

Active Comparator group

Description:

Usual Care with the provision of documentation on simple recommendations for the prevention of falls and aging well.

Treatment:

Other: Usual care