Pauget Alexandrine, Jomard Nathalie, Termoz Anne, Subtil Fabien, Chambard Véronique, Galamand Béatrice, Genest Evelyne, Chapelet Guillaume, Bonnefoy Marc
Court séjour gériatrique, Hôpital Nord-Ouest, Villefranche, France
Unité mobile extrahospitalière de gériatrie, Service universitaire de gériatrie, Centre hospitalier de Lyon-Sud, Lyon, France
Geriatr Psychol Neuropsychiatr Vieil. 2022 Jun 1;20(2):208-216. doi: 10.1684/pnv.2022.1036.
Mobile geriatric team making home visit (MGT) were created to reinforce the link between home and hospital. Frail elderly patients can benefit from a comprehensive geriatric assessment (CGA) by a geriatric mobile team during a home visit. MGT at the hospital center of Lyon Sud presents recommendations after a CGA to better adjust healthcare to patients’ needs. There are few studies that have analysed the MGT who treat patients at home.
The goal of the study was to determine adherence rate at 2 months and examines the socio-demographic profile of patients assessed by the MGT. We conducted a descriptive and retrospective study in single center, with 500 patients during 2 years (2016-2017).
The mean adherence rate was 65,1%. The highest rate concerned recommendations on the future orientation. The lower rate concerned recommendations on lifestyle and environment. Mean age of the 500 patients was 83.5 years, 61% were women. The patients included in this study take an average of seven prescription medications (whitout psychotropic medications). The majority of the patients was GIR 3 and achieved an average score of 3 on ADL scale and 2 of IADL scale. Ninety-six per cent of the patients had a caregiver. It has been proven statistically that, adherence rate of recommendations (more than 65%), reduce unplanned hospitalizations.
This study with a large sample of patients allows to better describe patients seen at home. It is a vulnerable population presenting a polypathology, dependence, associated with an unstable socio-family context. This work shows that the recommendations must be applied to limit hospitalizations and that the involvement of the team makes it possible to improve the follow-up of the recommendations.
设立了移动老年医学团队上门探访服务（MGT），以加强家庭与医院之间的联系。体弱的老年患者可在上门探访期间受益于老年医学移动团队进行的综合老年医学评估（CGA）。里昂南部医院中心的MGT在CGA后提出建议，以便更好地根据患者需求调整医疗保健服务。很少有研究分析过在家治疗患者的MGT。
本研究的目的是确定2个月时的依从率，并研究接受MGT评估的患者的社会人口学特征。我们在单中心进行了一项描述性回顾性研究，在2年（2016 - 2017年）期间纳入了500名患者。
平均依从率为65.1%。最高的依从率涉及关于未来方向的建议。最低的依从率涉及关于生活方式和环境的建议。500名患者的平均年龄为83.5岁，61%为女性。本研究纳入的患者平均服用七种处方药（不包括精神药物）。大多数患者为GIR 3级，在日常生活活动（ADL）量表上平均得分为3分，在工具性日常生活活动（IADL）量表上平均得分为2分。96%的患者有一名照顾者。经统计学证明，建议的依从率（超过65%）可减少非计划住院。
这项对大量患者的研究有助于更好地描述在家接受诊疗的患者情况。这是一个脆弱的群体，存在多种疾病、依赖他人，且社会家庭环境不稳定。这项工作表明，必须应用这些建议以限制住院，并且团队的参与能够改善对建议的跟进。
