Piedallu Jean-Baptiste, Lorenzo-Villalba Noël, Chassagne Philippe, Schuers Mathieu, Zulfiqar Abrar-Ahmad
Département de médecine générale, CHU Rouen, France.
Département de médecine interne, Hôpital civil, CHRU Strasbourg, France.
Geriatr Psychol Neuropsychiatr Vieil. 2020 Mar 1;18(1):53-62. doi: 10.1684/pnv.2019.0840.
Screening and management of frail elderly patients is essential in general practice.
This study aims to describe and evaluate the knowledge about frailty, its screening tests and management in a population of general practice interns.
A prospective, descriptive and mono-centric study using an online survey was conducted. The 2018's promotion of general practice interns in Rouen's University participated. Evaluation of the general knowledge (e.g diagnostic criteria) and specific knowledge (e.g ranking different conditions such as: undernourishment leading to asthenia) and management algorithm (e.g to address the patient for geriatric evaluation) Results: 90 questionnaires were analyzed. Ten interns (11%) stated to know at least one screening test or to know a set of 4 major frailty criteria. Thirty four interns knew at least 4 frailty criteria (major or minor) and 46 interns had partial knowledge. Fried's phenotype was the most known. Seventy-five interns (83%) stated to know the frailty syndrome. However, 88% of the interns had little knowledge about its pathophysiology. Concerning frailty management, 78% (70 interns) stated to know how to screen frailty and prescribe first line treatments. Thirty-one among them knew how to reassess initial treatment if failure. In 59 interns (65%), identifying frailty would have led to a geriatric consultation. Seventy-nine interns (87%) were favorable to go through further training on frailty.
These general practice interns were able to identify frailty criterion but, in contrast, global understanding of the syndrome was missing. Further training about this topic seems to be necessary.
在全科医疗中，对体弱老年患者进行筛查和管理至关重要。
本研究旨在描述和评估全科医疗实习医生群体对衰弱的认识、其筛查测试及管理情况。
采用在线调查进行一项前瞻性、描述性单中心研究。鲁昂大学2018年的全科医疗实习医生参与其中。评估一般知识（如诊断标准）、特定知识（如对不同情况进行排序，如营养不良导致虚弱）及管理算法（如将患者转介进行老年评估）。结果：分析了90份问卷。10名实习医生（11%）表示至少知道一种筛查测试或一组4项主要衰弱标准。34名实习医生知道至少4项衰弱标准（主要或次要），46名实习医生有部分了解。弗里德表型最为人所知。75名实习医生（83%）表示知道衰弱综合征。然而，88%的实习医生对其病理生理学了解甚少。关于衰弱管理，78%（70名实习医生）表示知道如何筛查衰弱并开出一线治疗方案。其中31人知道如果治疗失败如何重新评估初始治疗。59名实习医生（65%）认为识别出衰弱会导致进行老年科会诊。79名实习医生（87%）赞成接受关于衰弱的进一步培训。
这些全科医疗实习医生能够识别衰弱标准，但相比之下，对该综合征缺乏整体理解。关于这个主题的进一步培训似乎很有必要。
