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Master Thesis

Profils et devenir des patients âgés en situation complexe à domicile évalués par l’équipe mobile de gériatrie extra hospitalière : impact du suivi des recommandations

Abstract : The Mobile Extra-Mural Geriatric Team of the CHU Grenoble-Alpes provides home-based care for frail elderly patients in a complex medico-social situation at the request of general practitioners. The characteristics and becoming of this community-dwelling population are poorly studied. This study aimed to: 1) describe the target population, 2) the recommendations made, 3) their adherence rate at 3 months, 4) the factors influencing the adherence and 5) major events: death, hospitalization, functional loss, institutionalization to 3 months. In 3 years, 69 patients were prospectively analyzed: mean age 86.4 years, 72.5% frail, Activities Daily Living (ADL) average 3.1/6, and Iso Resource Group (GIR) average 2.8/6. Patients were polypathological, 90% with a neuropsychiatric pathology. Patients were 36% alone at home, 64% had a supportive environment and 64.5% of caregivers were exhausted. The average was 5.8 recommendations per patient. The total adherence of recommendations at 3 months was 95% with 90% adherence for the medical recommendations, 67% for the home care and 74% for the medico-social. The number of recommendations, the "supportive" status of the environment and the caregiver's burden do not influence recommendations’ adherence at 3-month in this study. At 3 months, 10% of patients have died, 22% entered institutional care, 22% were hospitalized, of whom only 13% in Emergency Department and 3% for unsuitable reasons. Mean ADL and GIR scores decreased significantly by 0.3 pt /6. Recommendations’ adherence does not influence mortality, functional loss and proportion of hospitalization, and entry in institution at 3 months in this study.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01920309
Contributor : Jean-Hugues Morneau <>
Submitted on : Thursday, November 15, 2018 - 9:52:11 AM
Last modification on : Wednesday, July 15, 2020 - 8:58:04 AM
Long-term archiving on: : Saturday, February 16, 2019 - 12:32:52 PM

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  • HAL Id : dumas-01920309, version 1

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Aude Richard. Profils et devenir des patients âgés en situation complexe à domicile évalués par l’équipe mobile de gériatrie extra hospitalière : impact du suivi des recommandations. Médecine humaine et pathologie. 2018. ⟨dumas-01920309⟩

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