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

Primary Purpose

Dementia in Nursing Home

Status
Completed
Phase
Not Applicable
Locations
France
Study Type
Interventional
Intervention
MultiDisciplinary Team Meetings (MDTM)
Sponsored by
University Hospital, Toulouse
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Dementia in Nursing Home focused on measuring Dementia, emergency hospitalization, nursing home, multidisciplinary meeting, cognitive decline, disability, residents, facilities, long term care unit, health policy, general practitioner, prevention

Eligibility Criteria

60 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

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

Sites / Locations

  • Centre de Gerontologie Pompeyrie Chu Agen
  • Ehpad Maison de Retraite Louise Anceau
  • Ehpad Maison de Retraite Olga Ducoudray
  • Ehpad Mr "Les Jardins de Jouvence"
  • Mapad La Renaudie Ch Albi
  • Ehpad Les Ajoncs D'Or
  • Ehpad Maison de Retraite Hl Ax Les Thermes
  • Ehpad Marie Lehman
  • Ehpad Kerdigemer
  • Ehpad Residence Ker-Heol
  • Ehpad Residence Saint Astier
  • Mapa de L'Hopital Local de Caussade
  • Ehpad Maison de Retraite Ste Marthe
  • EHPAD Résidence Castelgirou
  • Ehpad Leon Ronzier Joly
  • Ehpad Themis Lasplanes
  • Ehpad Maison de Retraite Joseph Sauvy
  • Ehpad Residence Borde Haute Promo-Accueil
  • Mapad "Firmi"
  • Ehpad Hopital Local Fleurance
  • Ehpad Mr Bellissen Chi Du Val D'Ariege
  • Ehpad Dr Robert
  • Ehpad Residence Grand'Maison
  • Ehpad Residence Provencale Medicafrance
  • Ehpad Residence Clairefontaine
  • Mapad Ch Lavaur
  • Ehpad Saint Reah Hir
  • Ehpad Residence D'Automne de La Ferme
  • Ehpad Maison de Retraite "Les Charmilles"
  • Residence Le Parc
  • Ehpad La Cheneraie
  • Ehpad Mr Lagrange
  • Mapad Labastide Ch Lourdes
  • Ehpad Emile Dubois
  • Ehpad Les Mille Soleils
  • Ehpad Et. Public Gerontologie de Marines
  • AP-HM Hôptal La Timone Service de Pédiatrie Mutidisciplinaire
  • Ehpad Maison Retraite Hl Mauvezin
  • Ehpad Maison de Retraite Saint Joseph
  • Ehpad Maison de Retraite Privee de Mazeres
  • Ehpad-Maison Retraite Hl Mirande
  • Ehpad Chis Castelsarrasin-Moissac
  • Ehpad Era Caso
  • Ehpad Maison Retraite Ch Montauban
  • Ehpad Ma Maison
  • Ehpad Maison de Retraite Sainte Agnes
  • Ehpad L'Ecrin Des Sages
  • Ehpad L'Acacia
  • Logements Foyer La Fontanelle
  • Ehpad Fondation Pauliani
  • Ehpad Les Noisetiers
  • Ehpad Residence Ancilla
  • Ehpad Mais de Retraite Saint-Joseph
  • Ehpad Mr Bariol Chi Du Val D'Ariege
  • Ehpad Residence Le Parc
  • AP-HP Hôpital Necker Enfants Malades Service d'endocrinologie pédiatrique - 149 route de Sèvres
  • Ehpad Furtado Heine
  • Ehpad Julie Siegfried
  • Ehpad La Pirandelle
  • Ehpad Residence Anselme
  • Ehpad Residence Belleville
  • Ehpad Residence Herold
  • Ehpad Residence Oceane
  • Ehpad Tiers Temps Paris
  • Ehpad Residence Adeline
  • Ehpad Residence D'Automne Medica-France
  • Ehpad L'Oree Du Bois
  • Ehpad Residence Saint-Amans
  • Ehpad Le Jardin Des Loges
  • Ehpad Residence Themis La Joie de Vivre
  • Ehpad A Labouilhe
  • Ehpad Public de Saint-Remy de Provence
  • Ehpad Les Bruyeres
  • Ehpad Maison Retraite Orelia Ch St Gaudens
  • Ehpad Genevriers
  • Ehpad Maison de Retraite Chic Tarbes Vic
  • Ehpad Residence "Le Doyenne Du Carmel"
  • Ehpad Sainte Anne
  • Ehpad de La Cote Pavee
  • Ehpad Gaubert
  • Ehpad Mr Henri Iv
  • Ehpad Pierre Ducis
  • Ehpad Residence La Cotonniere
  • Ehpad Residence Le Clos Des Carmes
  • Ehpad Residence Marguerite
  • Ehpad Residence Saint-Simon
  • Usld Domaine de La Cadene
  • Ehpad Umt
  • Ehpad Maisonneuve
  • Ehpad Saint-Jacques

Arms of the Study

Arm 1

Arm 2

Arm Type

Other

No Intervention

Arm Label

Intervention group

control group

Arm Description

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

Outcomes

Primary Outcome Measures

Incidence of hospitalizations in emergency care units
Monthly collection during follow-up (18 months)

Secondary Outcome Measures

Prevalence of antipsychotic prescription
Incidence of inappropriate hospitalizations
Monthly collection during follow-up (18 months)
Prevalence of neuropsychiatric symptoms evaluated by NPI-nursing staff version
Dependency evaluated by AGGIR and IADL-4 items
Quality of life evaluated by QOL-AD
Number of nursing staff's time off work
Monthly collection during follow-up (18 months)
Number of days off work by nursing staff
Monthly collection during follow-up (18 months)
Presence of advanced care planning in patients medical records
Advanced care planning will be checked through behavioural disosders, transfer to hospital intensive care and resuscitation
Overall healthcare costs
Monthly collection during follow-up (18 months)

Full Information

First Posted
July 4, 2011
Last Updated
July 28, 2020
Sponsor
University Hospital, Toulouse
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1. Study Identification

Unique Protocol Identification Number
NCT01569997
Brief Title
Impact of Systematic Tracking of Dementia Cases on the Rate of Hospitalization in Emergency Care Units
Acronym
IDEM
Official Title
Interest of Systematic Tracking of Dementia Cases in Nursing Homes: Analysing the Contribution of MultiDisciplinary Team Meeting (MDTM) in Alzheimer's Disease and Related Diseases
Study Type
Interventional

2. Study Status

Record Verification Date
July 2020
Overall Recruitment Status
Completed
Study Start Date
May 2010 (undefined)
Primary Completion Date
September 2013 (Actual)
Study Completion Date
September 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University Hospital, Toulouse

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
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
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.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Dementia in Nursing Home
Keywords
Dementia, emergency hospitalization, nursing home, multidisciplinary meeting, cognitive decline, disability, residents, facilities, long term care unit, health policy, general practitioner, prevention

7. Study Design

Primary Purpose
Prevention
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
1428 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Intervention group
Arm Type
Other
Arm Description
Intervention group: nursing homes whose residents benefit from MDTM to identify the cases of dementia and to propose an adequate care project
Arm Title
control group
Arm Type
No Intervention
Arm Description
Control group: nursing homes whose residents continue to benefit from usual care
Intervention Type
Other
Intervention Name(s)
MultiDisciplinary Team Meetings (MDTM)
Intervention Description
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...)
Primary Outcome Measure Information:
Title
Incidence of hospitalizations in emergency care units
Description
Monthly collection during follow-up (18 months)
Time Frame
18 months
Secondary Outcome Measure Information:
Title
Prevalence of antipsychotic prescription
Time Frame
Baseline visit, 4 months, 18 months
Title
Incidence of inappropriate hospitalizations
Description
Monthly collection during follow-up (18 months)
Time Frame
18 months
Title
Prevalence of neuropsychiatric symptoms evaluated by NPI-nursing staff version
Time Frame
Baseline visit, 18 months
Title
Dependency evaluated by AGGIR and IADL-4 items
Time Frame
Baseline visit, 18 months
Title
Quality of life evaluated by QOL-AD
Time Frame
Baseline visit, 18 months
Title
Number of nursing staff's time off work
Description
Monthly collection during follow-up (18 months)
Time Frame
18 months
Title
Number of days off work by nursing staff
Description
Monthly collection during follow-up (18 months)
Time Frame
18 months
Title
Presence of advanced care planning in patients medical records
Description
Advanced care planning will be checked through behavioural disosders, transfer to hospital intensive care and resuscitation
Time Frame
Baseline visit, 18 months
Title
Overall healthcare costs
Description
Monthly collection during follow-up (18 months)
Time Frame
18 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
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
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Pierre ALLAN, MD
Organizational Affiliation
EHPAD MAISON DE RETRAITE SAINT JOSEPH - MAZAMET
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Véronique ARNAUD-ULLIET, MD
Organizational Affiliation
EHPAD MA MAISON MONTPELLIER
Official's Role
Principal Investigator
Facility Information:
Facility Name
Centre de Gerontologie Pompeyrie Chu Agen
City
Agen
Country
France
Facility Name
Ehpad Maison de Retraite Louise Anceau
City
Albi
Country
France
Facility Name
Ehpad Maison de Retraite Olga Ducoudray
City
Albi
Country
France
Facility Name
Ehpad Mr "Les Jardins de Jouvence"
City
Albi
Country
France
Facility Name
Mapad La Renaudie Ch Albi
City
Albi
Country
France
Facility Name
Ehpad Les Ajoncs D'Or
City
Allaire
Country
France
Facility Name
Ehpad Maison de Retraite Hl Ax Les Thermes
City
Ax-les-Thermes
Country
France
Facility Name
Ehpad Marie Lehman
City
Balma
Country
France
Facility Name
Ehpad Kerdigemer
City
Brest
Country
France
Facility Name
Ehpad Residence Ker-Heol
City
Brest
Country
France
Facility Name
Ehpad Residence Saint Astier
City
Catus
Country
France
Facility Name
Mapa de L'Hopital Local de Caussade
City
Caussade
Country
France
Facility Name
Ehpad Maison de Retraite Ste Marthe
City
Ceignac
Country
France
Facility Name
EHPAD Résidence Castelgirou
City
Cepet
Country
France
Facility Name
Ehpad Leon Ronzier Joly
City
Clermont L'herault
Country
France
Facility Name
Ehpad Themis Lasplanes
City
Colomiers
Country
France
Facility Name
Ehpad Maison de Retraite Joseph Sauvy
City
ERR
Country
France
Facility Name
Ehpad Residence Borde Haute Promo-Accueil
City
Escalquens
Country
France
Facility Name
Mapad "Firmi"
City
Firmi
Country
France
Facility Name
Ehpad Hopital Local Fleurance
City
Fleurance
Country
France
Facility Name
Ehpad Mr Bellissen Chi Du Val D'Ariege
City
Foix
Country
France
Facility Name
Ehpad Dr Robert
City
Guer
Country
France
Facility Name
Ehpad Residence Grand'Maison
City
L'union
Country
France
Facility Name
Ehpad Residence Provencale Medicafrance
City
La Roquebrussanne
Country
France
Facility Name
Ehpad Residence Clairefontaine
City
Lamorlaye
Country
France
Facility Name
Mapad Ch Lavaur
City
Lavaur
Country
France
Facility Name
Ehpad Saint Reah Hir
City
Le Conquet
Country
France
Facility Name
Ehpad Residence D'Automne de La Ferme
City
Le Mee Sur Seine
Country
France
Facility Name
Ehpad Maison de Retraite "Les Charmilles"
City
Lescure d'Albigeois
Country
France
Facility Name
Residence Le Parc
City
Lezat Sur Leze
Country
France
Facility Name
Ehpad La Cheneraie
City
Lherm
Country
France
Facility Name
Ehpad Mr Lagrange
City
Lisle Sur Tarn
Country
France
Facility Name
Mapad Labastide Ch Lourdes
City
Lourdes
Country
France
Facility Name
Ehpad Emile Dubois
City
Marchiennes
Country
France
Facility Name
Ehpad Les Mille Soleils
City
Marciac
Country
France
Facility Name
Ehpad Et. Public Gerontologie de Marines
City
Marines
Country
France
Facility Name
AP-HM Hôptal La Timone Service de Pédiatrie Mutidisciplinaire
City
Marseille
ZIP/Postal Code
13385
Country
France
Facility Name
Ehpad Maison Retraite Hl Mauvezin
City
Mauvezin
Country
France
Facility Name
Ehpad Maison de Retraite Saint Joseph
City
Mazamet
Country
France
Facility Name
Ehpad Maison de Retraite Privee de Mazeres
City
Mazeres
Country
France
Facility Name
Ehpad-Maison Retraite Hl Mirande
City
Mirande
Country
France
Facility Name
Ehpad Chis Castelsarrasin-Moissac
City
Moissac
Country
France
Facility Name
Ehpad Era Caso
City
Montauban de Luchon
Country
France
Facility Name
Ehpad Maison Retraite Ch Montauban
City
Montauban
Country
France
Facility Name
Ehpad Ma Maison
City
Montpellier
Country
France
Facility Name
Ehpad Maison de Retraite Sainte Agnes
City
Montredon Labessonnie
Country
France
Facility Name
Ehpad L'Ecrin Des Sages
City
Mèze
Country
France
Facility Name
Ehpad L'Acacia
City
Nailloux
Country
France
Facility Name
Logements Foyer La Fontanelle
City
Naucelle
Country
France
Facility Name
Ehpad Fondation Pauliani
City
Nice
Country
France
Facility Name
Ehpad Les Noisetiers
City
Nice
Country
France
Facility Name
Ehpad Residence Ancilla
City
Nice
Country
France
Facility Name
Ehpad Mais de Retraite Saint-Joseph
City
Ossun
Country
France
Facility Name
Ehpad Mr Bariol Chi Du Val D'Ariege
City
Pamiers
Country
France
Facility Name
Ehpad Residence Le Parc
City
Panazol
Country
France
Facility Name
AP-HP Hôpital Necker Enfants Malades Service d'endocrinologie pédiatrique - 149 route de Sèvres
City
Paris
ZIP/Postal Code
75015
Country
France
Facility Name
Ehpad Furtado Heine
City
Paris
Country
France
Facility Name
Ehpad Julie Siegfried
City
Paris
Country
France
Facility Name
Ehpad La Pirandelle
City
Paris
Country
France
Facility Name
Ehpad Residence Anselme
City
Paris
Country
France
Facility Name
Ehpad Residence Belleville
City
Paris
Country
France
Facility Name
Ehpad Residence Herold
City
Paris
Country
France
Facility Name
Ehpad Residence Oceane
City
Paris
Country
France
Facility Name
Ehpad Tiers Temps Paris
City
Paris
Country
France
Facility Name
Ehpad Residence Adeline
City
Pierre Buffiere
Country
France
Facility Name
Ehpad Residence D'Automne Medica-France
City
Reims
Country
France
Facility Name
Ehpad L'Oree Du Bois
City
Rieux Volvestre
Country
France
Facility Name
Ehpad Residence Saint-Amans
City
Rodez
Country
France
Facility Name
Ehpad Le Jardin Des Loges
City
Saint Bonnet
Country
France
Facility Name
Ehpad Residence Themis La Joie de Vivre
City
Saint Lys
Country
France
Facility Name
Ehpad A Labouilhe
City
Saint Orens de Gameville
Country
France
Facility Name
Ehpad Public de Saint-Remy de Provence
City
Saint Remy de Provence
Country
France
Facility Name
Ehpad Les Bruyeres
City
Sousceyrac
Country
France
Facility Name
Ehpad Maison Retraite Orelia Ch St Gaudens
City
St Gaudens
Country
France
Facility Name
Ehpad Genevriers
City
St Martory
Country
France
Facility Name
Ehpad Maison de Retraite Chic Tarbes Vic
City
Tarbes
Country
France
Facility Name
Ehpad Residence "Le Doyenne Du Carmel"
City
Tarbes
Country
France
Facility Name
Ehpad Sainte Anne
City
Tinteniac
Country
France
Facility Name
Ehpad de La Cote Pavee
City
Toulouse
Country
France
Facility Name
Ehpad Gaubert
City
Toulouse
Country
France
Facility Name
Ehpad Mr Henri Iv
City
Toulouse
Country
France
Facility Name
Ehpad Pierre Ducis
City
Toulouse
Country
France
Facility Name
Ehpad Residence La Cotonniere
City
Toulouse
Country
France
Facility Name
Ehpad Residence Le Clos Des Carmes
City
Toulouse
Country
France
Facility Name
Ehpad Residence Marguerite
City
Toulouse
Country
France
Facility Name
Ehpad Residence Saint-Simon
City
Toulouse
Country
France
Facility Name
Usld Domaine de La Cadene
City
Toulouse
Country
France
Facility Name
Ehpad Umt
City
Valence-d'albigeois
Country
France
Facility Name
Ehpad Maisonneuve
City
Villefranche de Lauragais
Country
France
Facility Name
Ehpad Saint-Jacques
City
Villemur Sur Tarn
Country
France

12. IPD Sharing Statement

Citations:
PubMed Identifier
32101308
Citation
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.
Results Reference
result

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

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