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Master Thesis

Chute du sujet âgé‎ : prévalence et parcours de soins en médecine générale‎ : une étude transversale déclarative multicentrique

Abstract : aContext: Each year, one out of three seniors over 65 years falls. This event is responsible for major comorbidities and is an entry into the loss of autonomy. Effective care of the falls remains limited, despite the fact that its complications are now well known. The main objective of this study was to develop a description of the course of treatment followed by the patients after a fall. The secondary objectives were to study, in the patient base of general practice, the prevalence of falls and the characteristics of seniors who fall, the description by the patient of the consequences of falls and the study of the reasons why patients inadequately inform their doctor or their entourage of their falls. Method: We realized a descriptive cross-sectional multicenter epidemiological study based on a collection of data concerning falls using a self-administered questionnaire delivered to patients over 65 consulting in general practice between November 2011 and May 2012. Results: 358 questionnaires were analyzed including 124 fallers. The study showed a prevalence of falls in general practice of 35% (95% CI = 30-40). In one third of the cases, no one was aware of the fall, even if it was accompanied by sometimes major secondary consequences. For the remaining 2/3, the entourage was consulted in ¼ of the cases, and the medical community in half of the cases. The other paramedical communities were rarely involved. The multiplication of falls did not lead to more consultation. Among the 124 fallers, a medical consultation was realized in only one case out of two while 75% of the falls were complicated. Patients did not consult (43%) because of a lack of interest in a screening for risk factors. Almost all fallers (92% mono-fallers and 96% poly-fallers) had at least one of the HAS gravity criteria and would deserve a thorough examination as secondary prevention. Less than 10% of these patients had received it. Among non-fallers, 64% had at least one gravity criteria and 5% reported having received targeted screening. In this study, risk factors for falls were a history of fracture after 50 years old, antidepressants and anxiolytics; and in poly-fallers taking sleeping pills, history of osteoporosis and an age greater than 80 years. Conclusion: The falls are undervalued because of a lack of information of the patients and their entourage on the importance of a medical screening after a fall, and because of the minimizing of the consequences by the patients. Implementation and evaluation of information on the risks of falls, and the interest of screening targeting patients and their families may allow an improvement in primary and secondary prevention.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-00750318
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Submitted on : Friday, November 9, 2012 - 2:30:31 PM
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  • HAL Id : dumas-00750318, version 1

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Thérence Demeocq. Chute du sujet âgé‎ : prévalence et parcours de soins en médecine générale‎ : une étude transversale déclarative multicentrique. Médecine humaine et pathologie. 2012. ⟨dumas-00750318⟩

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