Outpatient Hospitalization of Unaccompanied Patients at Home for Endovascular Treatment of Peripheral Arterial Disease.

NCT ID: NCT05756491

Last Updated: 2024-01-16

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

RECRUITING

Clinical Phase

NA

Total Enrollment

2000 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-04-11

Study Completion Date

2026-04-11

Brief Summary

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In Westernized countries, the prevalence of peripheral arterial disease (PAD) is estimated at 15-20% of subjects over 70 years of age and is increasing considerably because of the aging of the population and the increasing prevalence of diabetes and renal insufficiency. In response to this increase in incidence, vascular surgeons must develop innovative treatments that minimize the use of resources in a context of budgetary constraints, in patients who are increasingly well informed, while maintaining the safety and effectiveness of the procedures performed.

The endovascular technique has several advantages. First, it is a minimally invasive treatment, most often performed under local anesthesia. Secondly, the duration of the procedure and the length of hospitalization are reduced. In addition, the peri-operative morbidity and mortality is extremely low.

In France, for many years, public health policies have encouraged the development of outpatient hospitalization. Endovascular treatment allows the development of outpatient care. The French Society of Vascular and Endovascular Surgery (SCVE) was the first European society to publish recommendations concerning the outpatient management of endovascular treatment of PAD. These recommendations aim to promote the development of outpatient treatment by providing a framework for practitioners wishing to offer this type of management.

Concerning the patient and according to the SCVE recommendations, all types of occlusive arterial lesions of the lower limbs can be managed on an outpatient basis and only patients with severe comorbidities are excluded from this type of hospitalization. In addition, various studies have shown the safety of outpatient hospitalization for PAD. The absence of an accompanying person on the night following the procedure is considered an exclusion criterion for outpatient care.

The objective of this Stepped-wedge Cluster Randomized Controlled Trial is to increase the use of outpatient hospitalization for endovascular treatment of PAD by proposing a care pathway adapted to people without an accompanying person on the night of the procedure at home.

Detailed Description

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Conditions

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Peripheral Arterial Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

standard care: accompanied patients Remote surveillance: unaccompanied patients
Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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Experimental: Group1

In group 1: 5 centers will be randomized for the inclusion of unaccompanied patients for 24 months

Group Type EXPERIMENTAL

24 months of inclusion of unaccompanied patients

Intervention Type OTHER

inclusion for 6 months of accompanied patients in conventional outpatient care (observational period) and then inclusion for 24 months of unaccompanied with remonte surveillance patients and accompanied patients (interventional period)

Experimental: Group2

In group 2: 5 other centers will be randomized for the inclusion of unaccompanied patients for 18 months

Group Type EXPERIMENTAL

18 months of inclusion of unaccompanied patients

Intervention Type OTHER

inclusion for 12 months of accompanied patients in conventional outpatient care (observational period) and then inclusion for 18 months of unaccompanied with remonte surveillance patients and accompanied patients (interventional period)

Experimental: Group3

In group 3: 5 other centers will be randomized for the inclusion of unaccompanied patients for 12 months

Group Type EXPERIMENTAL

12 months of inclusion of unaccompanied patients

Intervention Type OTHER

inclusion for 18 months of accompanied patients in conventional outpatient care (observational period) and then inclusion for 12 months of unaccompanied with remonte surveillance patients and accompanied patients (interventional period)

Experimental: Group4

In group 4: 5 other centers will be randomized for the inclusion of unaccompanied patients for 6 months

Group Type EXPERIMENTAL

6 months of inclusion of unaccompanied patients

Intervention Type OTHER

inclusion for 24 months of accompanied patients in conventional outpatient care (observational period) and then inclusion for 6 months of unaccompanied with remonte surveillance patients and accompanied patients (interventional period)

Interventions

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24 months of inclusion of unaccompanied patients

inclusion for 6 months of accompanied patients in conventional outpatient care (observational period) and then inclusion for 24 months of unaccompanied with remonte surveillance patients and accompanied patients (interventional period)

Intervention Type OTHER

18 months of inclusion of unaccompanied patients

inclusion for 12 months of accompanied patients in conventional outpatient care (observational period) and then inclusion for 18 months of unaccompanied with remonte surveillance patients and accompanied patients (interventional period)

Intervention Type OTHER

12 months of inclusion of unaccompanied patients

inclusion for 18 months of accompanied patients in conventional outpatient care (observational period) and then inclusion for 12 months of unaccompanied with remonte surveillance patients and accompanied patients (interventional period)

Intervention Type OTHER

6 months of inclusion of unaccompanied patients

inclusion for 24 months of accompanied patients in conventional outpatient care (observational period) and then inclusion for 6 months of unaccompanied with remonte surveillance patients and accompanied patients (interventional period)

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patient with symptomatic PAD (Rutherford 1-5) requiring endovascular revascularization that can be performed on an outpatient basis
* Procedure listed in the Common Classification of Medical Procedures
* Patient with a good understanding of the constraints of the study
* Patient with an ASA score of 1 to 3 (stable)
* Patient registered with the social security system
* Patient living less than 1 hour by car from the care facility or from a care facility able to care for this type of patient
* Patient willing to remain hospitalized if necessary

For accompanied patients only:

\- Patient does not object to the processing of his or her data

Only for isolated patients:

* Patient with free, informed and written consent
* Patient agreeing to wear the remote monitoring device at discharge from the outpatient revascularization hospitalization
* Patient agreeing to the processing of his or her personal data with the remote monitoring provider
* Patient not living in an area not served by a cell phone network (white zone)

Exclusion Criteria

* \- Disorders of hemostasis
* Acute ischemia of the lower limbs
* Patient already included in ABALONE (2nd inclusion impossible)
* Patient already included in a type 1 interventional research protocol
* Patient under guardianship or curatorship
* Patient deprived of liberty
* Patient under legal protection
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Fondation Hôpital Saint-Joseph

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Chu Jean Minjoz

Besançon, , France

Site Status RECRUITING

Centre Hospitalier de Béziers,

Béziers, , France

Site Status RECRUITING

Hopital Universitaire Ambroise Paré,

Boulogne-Billancourt, , France

Site Status RECRUITING

CHRU Cavale Blanche

Brest, , France

Site Status RECRUITING

Chu Cote de Nacre

Caen, , France

Site Status RECRUITING

Hôpital Universitaire Gabriel Montpied

Clermont-Ferrand, , France

Site Status RECRUITING

Pôle médical du Grand large,

Décines-Charpieu, , France

Site Status RECRUITING

Hopital Le Bocage,

Dijon, , France

Site Status RECRUITING

Hopital Prive Dijon Bourgogne

Dijon, , France

Site Status RECRUITING

Clinique Mutualiste Porte de L'Orient

Lorient, , France

Site Status RECRUITING

Chu de Nantes

Nantes, , France

Site Status RECRUITING

Hopital Prive Du Confluent

Nantes, , France

Site Status RECRUITING

Chu de Nice,

Nice, , France

Site Status RECRUITING

Hôpital Saint Joseph

Paris, , France

Site Status RECRUITING

Polyclinique Francheville,

Périgueux, , France

Site Status RECRUITING

Clinique de L'Europe

Rouen, , France

Site Status RECRUITING

Centre Hospitalier Yves Le Foll-

Saint-Brieuc, , France

Site Status RECRUITING

Centre Hospitalier Privé SAINT GREGOIRE

Saint-Grégoire, , France

Site Status RECRUITING

Clinique Esquirol-Saint-Hilaire,

Saint-Hilaire, , France

Site Status RECRUITING

Médipôle Lyon Villeurbanne,

Villeurbanne, , France

Site Status RECRUITING

Countries

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France

Central Contacts

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Yann GOUEFFIC

Role: CONTACT

+33 (0)1 44 12 75 91

Florence LECERF

Role: CONTACT

+33 (0) 1 40 94 25 17

Other Identifiers

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2022-A01201-42

Identifier Type: -

Identifier Source: org_study_id

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