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Master Thesis

Impact de la précarité sur le fardeau du traitement chez les patients multimorbides

Abstract : Introduction: in France, chronic diseases affect about 20 million people. The more patients have an increasing number of concomitant chronic diseases, the more their treatment burden increases. We wondered whether precariousness could be a predictor of the significant treatment burden in multimorbid patients. This is the main objective of our study. Material and method: this is a descriptive, observational, quantitative, multicenter, cross-sectional study from major multi-morbid patients recruited from general practitioner offices in Gironde between March and May 2018. Patients filled in a questionnaire assessing their precariousness level from the EPICES score and their treatment burden from the TBQ score. Patients filled in a questionnaire that allowed us to assess their precariousness level thanks to the EPICES score and their treatment burden based on the TBQ score. Results: one hundred and twelve eligible patients accepted to fill in the questionnaire from 10 different general practitioner offices. Ninety-six questionnaires were really analyzed for statistics. The average number of chronic diseases per patient was 3.65. The patients average EPICES score was 27.39 with a standard deviation of 19.24. On the 106 patients, 65 were defined as "non-precarious" according to the EPICES score and 41 as "precarious". The average TBQ score of studied population was 28.53 (standard deviation: 20.29). The treatment burden difference between "precarious" and "non-precarious" patients group was not statistically significant (p = 0.51). It has not been shown correlation between the EPICES score and the TBQ score (p = 0.21). Among the other variables analyzed, having a caregiver (p = 0.02) or a psychiatric illness (p = 0.04) or a young age (p = 0.0004) or not being retired (p = 0.00007) were identified as predictors of a high treatment burden. Conclusion: this is the first study that evaluates the impact of precariousness on the treatment burden in multimorbid patients. Precariousness does not appear to be a predictor of a significant treatment burden in multimorbid patients. Other factors are linked to an important burden: not being retired, being young, having a caregiver or psychiatric illness. This work reminds us that in order to implement an effective treatment programs that minimize the treatment burden, that is to say use "Minimally Disruptive Medicine" (33), practitioners and researchers need to be able to identify patients where the burden is more important.
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https://dumas.ccsd.cnrs.fr/dumas-02964114
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Charlotte Théodore. Impact de la précarité sur le fardeau du traitement chez les patients multimorbides. Sciences du Vivant [q-bio]. 2019. ⟨dumas-02964114⟩

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