Publications by authors named "Laure Martinez"

3 Publications

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[Therapeutic education in elderly over 75 years old living at home A pilot study of 48 patients].

Geriatr Psychol Neuropsychiatr Vieil 2020 03;18(1):43-52

Département de gérontologie clinique, CHU de Saint-Étienne, France.

Therapeutic patient education (TPE) allows elderly as well as young adults to evaluate patient's self-care and adaptation skills to their own clinical condition. Falling is a symptom present in various chronic diseases, which leads to loss of autonomy, fear of recidivism and frequent admissions into institutions. Study objective was to evaluate at 3 and 6 months the impact of TPE on fall recurrence, perceived quality of life and fear of falling, in elderly over 75 living at home.

Methods: We performed a prospective study comparing two groups: a group participating in day hospital (group "TPE") and a control group (group "Hospitalized") of elderly patient not receiving TPE recruited in short geriatric stays following a fall at home.

Results: 28 patients in the "TPE" group and 20 patients in the "Hospitalized" group were included. The "TPE" group reported significantly better perceived quality of life at 3 months and 6 months. At 6 months, fear of falling was twice as high in the "Hospitalized" group than in the "TPE" group.

Conclusions: The group of subjects who was able to benefit from therapeutic education at home had an improved quality of life at 3 and 6 months and a decrease in the fear of falling at 6 months.
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http://dx.doi.org/10.1684/pnv.2019.0841DOI Listing
March 2020

Impact of Geriatric Hotlines on Health Care Pathways and Health Status in Patients Aged 75 Years and Older: Protocol for a French Multicenter Observational Study.

JMIR Res Protoc 2020 Feb 13;9(2):e15423. Epub 2020 Feb 13.

Department of Clinical Gerontology, University Hospital of Saint-Etienne, Saint Etienne, France.

Background: In France, emergency departments (EDs) are the fastest and most common means for general practitioners (GPs) to cope with the complex issues presented by elderly patients with multiple conditions. EDs are overburdened, and studies show that being treated in EDs can have a damaging effect on the health of elderly patients. Outpatient care or planned hospitalizations are possible solutions if appropriate geriatric medical advice is provided. In 2013, France's regional health authorities proposed creating direct telephone helplines, "geriatric hotlines," staffed by geriatric specialists to encourage interactions between GP clinics and hospitals. These hotlines are designed to improve health care pathways and the health status of the elderly.

Objective: This study aims to describe the health care pathways and health status of patients aged 75 years and older hospitalized in short-stay geriatric wards following referral from a geriatric hotline.

Methods: The study will be conducted over 24 months in seven French university hospital centers. It will include all patients aged 75 and older, living in their own homes or nursing homes, who are admitted to short-stay geriatric wards following hotline consultation. Two questionnaires will be filled out by medical staff at specific time points: (1) after conducting the telephone consultation and (2) on admitting the patient to a short-stay geriatric medical care. The primary endpoint will be mean hospitalization duration. The secondary endpoints will be intrahospital mortality rate, the characteristics of patients admitted via the hotline, and the types of questions asked and responses given via the hotline.

Results: The study was funded by the National School for Social Security Loire department (École Nationale Supérieure de Sécurité Sociale) and the Conference for funders of prevention of autonomy loss for the elderly of the Loire department in November 2017. Institutional review board approval was obtained in April 2018. Data collection started in May 2018; the planned end date for data collection is May 2020. Data analysis will take place in the summer of 2020, and the first results are expected to be published in late 2020.

Conclusions: The results will reveal whether geriatric hotlines provide the most effective management of elderly patients, as indicated by shorter mean hospitalization durations. Shorter hospital durations could lead to a reduced risk of complications-geriatric syndromes-and the domino chain of geriatric conditions that follow. We will also describe different geriatric hotlines from different cities and compare how they function to improve the health care of the elderly and pave the way toward new advances, especially in the organization of the care path.

Trial Registration: ClinicalTrials.gov NCT03959475; https://clinicaltrials.gov/ct2/show/NCT03959475.

International Registered Report Identifier (irrid): DERR1-10.2196/15423.
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http://dx.doi.org/10.2196/15423DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7055780PMC
February 2020

[Interest of follow-up of recommendations over a period of 6 months for elderly subjects who have been screened for frailty].

Geriatr Psychol Neuropsychiatr Vieil 2019 06;17(2):145-152

Département de gérontologie clinique, Hôpital de la Charité, Saint-Étienne, France, Gérontopôle Auvergne Rhône-Alpes, Saint-Etienne, France.

Frailty is a partially reversible geriatric syndrome. Its prevention requires a structured screening, and is a major public health issue given the increasing life expectancy of the population. The observance of the recommendations made after a screening of the frailty patients is not well known. The objective of our research was to describe the characteristics of patients evaluated in a frailty-day-hospital and followed up recommendation adherence at 3 and 6 months.

Methods: patients aged over 65 years old with an ADL score of at least 5 out of 6, were evaluated according to the Fried score to classify patients into pre-frailty or frailty patients. According to the standardized geriatric assessment, recommendations were prescribed for each medico-social situation according to HAS recommendations. A follow-up assessment of these measures was carried out at home basis at 3 and 6 months.

Results: 82 patients were included, with mean age of 83.7±5.7 years. 99% were pre-frail or frail and received an average of 3.7±1.7 recommendations. At 3 months, there is an inverse correlation between number and follow-up compliance (r=-0.340, p=0.008), as well as at 6 months (r=-0.352, p=0.006). Between 3 and 6 months, there is a significant increase recommendation number followed (r=0.707, p=0.000).

Conclusion: at 6 months, 74.3% recommendations were realized, with a significant increase of recommendation number between the 3rd and 6th month. This result is encouraging by showing the benefit of home support in recommendations follow-up.
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http://dx.doi.org/10.1684/pnv.2018.0773DOI Listing
June 2019