Impact of Systematic Tracking of Dementia Cases on the Rate of Hospitalization in Emergency Care Units

NCT ID: NCT01569997

Last Updated: 2020-07-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

1428 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-05-31

Study Completion Date

2013-09-30

Brief Summary

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Introduction: Epidemiological data show that in France only half of patients with Alzheimer disease are currently diagnosed in the general population. The absence of early diagnosis of dementia reduces the opportunities of patients to receive optimal care. One of the consequences of undiagnosed dementia is inadequate use of emergency care units.

The main objective: The main aim of this study is to evaluate the impact of a systematic case-finding procedure of dementia cases in nursing homes through a MDTM on the rate of hospitalization in emergency care units.

Secondary objectives:

To assess the impact of systematic tracking of dementia cases on the:

* Quantity and quality of drug-prescription
* Appropriateness of hospitalizations
* Prevalence of neuropsychiatric symptoms
* Dependency
* Quality of life
* Burden of nursing staff working conditions
* Planning of specific therapeutic measures
* Overall health care costs

Detailed Description

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This is a multicentre, cluster randomized study comparing two parallel groups:

* Intervention group: nursing homes whose residents benefit from MDTM to identify the cases of dementia and to propose an adequate care project
* Control group: nursing homes whose residents continue to benefit from usual care In each group, 1000 elderly subjects aged over 60 years without documented diagnosis of dementia will be included and monitored for a period of 18 months.

Information about the main and secondary aims will be collected monthly through online questionnaires.

Conditions

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Dementia in Nursing Home

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Intervention group

Intervention group: nursing homes whose residents benefit from MDTM to identify the cases of dementia and to propose an adequate care project

Group Type OTHER

MultiDisciplinary Team Meetings (MDTM)

Intervention Type OTHER

The MDTM, between the memory experts and Nursing Home coordinating practitioners, could help the nursing home medical staff identify the cases of dementia and propose these residents an adequate healthcare project (supplementary investigations, therapeutic modifications, hospitalizations...)

control group

Control group: nursing homes whose residents continue to benefit from usual care

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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MultiDisciplinary Team Meetings (MDTM)

The MDTM, between the memory experts and Nursing Home coordinating practitioners, could help the nursing home medical staff identify the cases of dementia and propose these residents an adequate healthcare project (supplementary investigations, therapeutic modifications, hospitalizations...)

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Residents of both sex, aged 60 years or over
* Residents living in a nursing home participating in the study
* Residents living in the nursing home for 30 days or more
* Residents without diagnosed and documented dementia, identified as follows:

* residents not identified by the French Healthcare system as suffering from dementia (ALD 15)
* residents not benefiting from a specific care program or a specialized follow-up for dementia
* residents for whom there is no appropriate investigation for dementia diagnosis in medical records
* residents not taking specific drugs for dementia (Cholinesterase inhibitors and/or Memantine)
* Residents and their GP having received information about the study
* Residents and their GP having expressed their agreement to participate in the study

Exclusion Criteria

* Residents aged less than 60 years
* Residents not living in a nursing home participating in study
* Residents living in nursing home for less than 30 days
* Residents with diagnosed and documented dementia, identified as follows:

* residents Identified by the French Healthcare system as suffering from dementia (ALD 15)
* residents benefiting from specific care programme or specialized follow-up for dementia
* residents for whom there is appropriate investigation for dementia diagnosis in medical records
* residents taking specific drugs for dementia (Cholinesterase inhibitors and/or Memantine)
* Residents and/or their GP who received no information about the study
* Residents and/or their GP having expressed their opposition to participate in the study
Minimum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Toulouse

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Pierre ALLAN, MD

Role: PRINCIPAL_INVESTIGATOR

EHPAD MAISON DE RETRAITE SAINT JOSEPH - MAZAMET

Véronique ARNAUD-ULLIET, MD

Role: PRINCIPAL_INVESTIGATOR

EHPAD MA MAISON MONTPELLIER

Locations

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Centre de Gerontologie Pompeyrie Chu Agen

Agen, , France

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Ehpad Maison de Retraite Louise Anceau

Albi, , France

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Ehpad Maison de Retraite Olga Ducoudray

Albi, , France

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Ehpad Mr "Les Jardins de Jouvence"

Albi, , France

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Mapad La Renaudie Ch Albi

Albi, , France

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Ehpad Les Ajoncs D'Or

Allaire, , France

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Ehpad Maison de Retraite Hl Ax Les Thermes

Ax-les-Thermes, , France

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Ehpad Marie Lehman

Balma, , France

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Ehpad Kerdigemer

Brest, , France

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Ehpad Residence Ker-Heol

Brest, , France

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Ehpad Residence Saint Astier

Catus, , France

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Mapa de L'Hopital Local de Caussade

Caussade, , France

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Ehpad Maison de Retraite Ste Marthe

Ceignac, , France

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EHPAD Résidence Castelgirou

Cépet, , France

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Ehpad Leon Ronzier Joly

Clermont-l'Hérault, , France

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Ehpad Themis Lasplanes

Colomiers, , France

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Ehpad Residence Borde Haute Promo-Accueil

Escalquens, , France

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Ehpad Maison de Retraite Joseph Sauvy

Eurre, , France

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Mapad "Firmi"

Firmi, , France

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Ehpad Hopital Local Fleurance

Fleurance, , France

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Ehpad Mr Bellissen Chi Du Val D'Ariege

Foix, , France

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Ehpad Dr Robert

Guer, , France

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Ehpad Residence Grand'Maison

L'Union, , France

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Ehpad Residence Provencale Medicafrance

La Roquebrussanne, , France

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Ehpad Residence Clairefontaine

Lamorlaye, , France

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Mapad Ch Lavaur

Lavaur, , France

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Ehpad Saint Reah Hir

Le Conquet, , France

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Ehpad Residence D'Automne de La Ferme

Le Mée-sur-Seine, , France

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Ehpad Maison de Retraite "Les Charmilles"

Lescure-d'Albigeois, , France

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Residence Le Parc

Lézat-sur-Lèze, , France

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Ehpad La Cheneraie

Lherm, , France

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Ehpad Mr Lagrange

Lisle-sur-Tarn, , France

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Mapad Labastide Ch Lourdes

Lourdes, , France

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Ehpad Emile Dubois

Marchiennes, , France

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Ehpad Les Mille Soleils

Marciac, , France

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Ehpad Et. Public Gerontologie de Marines

Marines, , France

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AP-HM Hôptal La Timone Service de Pédiatrie Mutidisciplinaire

Marseille, , France

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Ehpad Maison Retraite Hl Mauvezin

Mauvezin, , France

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Ehpad Maison de Retraite Saint Joseph

Mazamet, , France

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Ehpad Maison de Retraite Privee de Mazeres

Mazères, , France

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Ehpad L'Ecrin Des Sages

Mèze, , France

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Ehpad-Maison Retraite Hl Mirande

Mirande, , France

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Ehpad Chis Castelsarrasin-Moissac

Moissac, , France

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Ehpad Maison Retraite Ch Montauban

Montauban, , France

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Ehpad Era Caso

Montauban-de-Luchon, , France

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Ehpad Ma Maison

Montpellier, , France

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Ehpad Maison de Retraite Sainte Agnes

Montredon-Labessonnié, , France

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Ehpad L'Acacia

Nailloux, , France

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Logements Foyer La Fontanelle

Naucelle, , France

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Ehpad Fondation Pauliani

Nice, , France

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Ehpad Les Noisetiers

Nice, , France

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Ehpad Residence Ancilla

Nice, , France

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Ehpad Mais de Retraite Saint-Joseph

Ossun, , France

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Ehpad Mr Bariol Chi Du Val D'Ariege

Pamiers, , France

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Ehpad Residence Le Parc

Panazol, , France

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AP-HP Hôpital Necker Enfants Malades Service d'endocrinologie pédiatrique - 149 route de Sèvres

Paris, , France

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Ehpad Furtado Heine

Paris, , France

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Ehpad Julie Siegfried

Paris, , France

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Ehpad La Pirandelle

Paris, , France

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Ehpad Residence Anselme

Paris, , France

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Ehpad Residence Belleville

Paris, , France

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Ehpad Residence Herold

Paris, , France

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Ehpad Residence Oceane

Paris, , France

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Ehpad Tiers Temps Paris

Paris, , France

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Ehpad Residence Adeline

Pierre-Buffière, , France

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Ehpad Residence D'Automne Medica-France

Reims, , France

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Ehpad L'Oree Du Bois

Rieux-Volvestre, , France

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Ehpad Residence Saint-Amans

Rodez, , France

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Ehpad Le Jardin Des Loges

Saint-Bonnet, , France

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Ehpad Maison Retraite Orelia Ch St Gaudens

Saint-Gaudens, , France

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Ehpad Residence Themis La Joie de Vivre

Saint-Lys, , France

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Ehpad Genevriers

Saint-Martory, , France

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Ehpad A Labouilhe

Saint-Orens-de-Gameville, , France

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Ehpad Public de Saint-Remy de Provence

Saint-Rémy-de-Provence, , France

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Ehpad Les Bruyeres

Sousceyrac, , France

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Ehpad Maison de Retraite Chic Tarbes Vic

Tarbes, , France

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Ehpad Residence "Le Doyenne Du Carmel"

Tarbes, , France

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Ehpad Sainte Anne

Tinténiac, , France

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Ehpad de La Cote Pavee

Toulouse, , France

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Ehpad Gaubert

Toulouse, , France

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Ehpad Mr Henri Iv

Toulouse, , France

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Ehpad Pierre Ducis

Toulouse, , France

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Ehpad Residence La Cotonniere

Toulouse, , France

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Ehpad Residence Le Clos Des Carmes

Toulouse, , France

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Ehpad Residence Marguerite

Toulouse, , France

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Ehpad Residence Saint-Simon

Toulouse, , France

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Usld Domaine de La Cadene

Toulouse, , France

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Ehpad Umt

Valence-d'Albigeois, , France

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Ehpad Maisonneuve

Villefranche-de-Lauragais, , France

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Ehpad Saint-Jacques

Villemur-sur-Tarn, , France

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Countries

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France

References

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Rolland Y, Tavassoli N, de Souto Barreto P, Perrin A, Laffon de Mazieres C, Rapp T, Hermabessiere S, Tournay E, Vellas B, Andrieu S. Systematic Dementia Screening by Multidisciplinary Team Meetings in Nursing Homes for Reducing Emergency Department Transfers: The IDEM Cluster Randomized Clinical Trial. JAMA Netw Open. 2020 Feb 5;3(2):e200049. doi: 10.1001/jamanetworkopen.2020.0049.

Reference Type RESULT
PMID: 32101308 (View on PubMed)

Other Identifiers

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2009-A01062-55

Identifier Type: OTHER

Identifier Source: secondary_id

0910701

Identifier Type: -

Identifier Source: org_study_id

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