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Therapeutic Intervention Code in a Cognitive Geriatric Unit

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ClinicalTrials.gov Identifier: NCT03408028
Recruitment Status : Completed
First Posted : January 23, 2018
Last Update Posted : January 23, 2018
Sponsor:
Information provided by (Responsible Party):
Murielle Surquin, Brugmann University Hospital

Brief Summary:

The diagnostic and therapeutic progresses, associated with modifications in lifestyle and socio-cultural level of populations, have led to a remarkable increase in life expectancy. At the same time, the increasing medicalization of the individual has eroded the traditional boundaries between health and illness, normal and pathological state. This leads to the patient losing his sense of ownership of his own death. If most patients died at home before the Second World War, 75% of the population dies in hospital or institution at the present date.

Most hospitals and care institutions have developed codes, in multidisciplinary internal consultation, to address the interruption or lack of implementation of treatments that make no sense from a medical point of vue. This avoids therapeutic relentlessness.The code in place within the CHU Brugmann is:

  • code A: no therapeutic restriction
  • code B: not to be resuscitated
  • code C: not to be intensively treated (no escalation in therapeutic treatments)
  • code D: best palliative care (progressive de-escalation in therapeutic treatments).

These codes are established in consultation with the patient or his legal representative and are re-evaluated in a multidisciplinary way every week.

Planning a care path and therefore establishing a therapeutic code is particularly important for people with cognitive impairment and dementia because the progressive loss of cognitive abilities complicates the process of decision making.

A large part of the admissions are made via the emergency department. For these patients, no therapeutic plan has been established beforehand. However, the perception of the functional and cognitive status of the patient directly influences the intensity of care provided. Cognitive disorders are a risk factor for the exclusion of access to palliative care for the elderly patient.

The objectives of this study are:

  • To establish a record of the therapeutic limitation codes in an acute cognitive geriatric unit
  • To correlate the therapeutic limitation code with the comorbidities of the patients

Condition or disease Intervention/treatment
Cognitive Impairment Other: Medical File consultation

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Study Type : Observational
Actual Enrollment : 310 participants
Observational Model: Cohort
Time Perspective: Retrospective
Official Title: Therapeutic Intervention Code in a Cognitive Geriatric Unit: Retrospective Analysis
Actual Study Start Date : April 1, 2017
Actual Primary Completion Date : October 1, 2017
Actual Study Completion Date : October 1, 2017

Group/Cohort Intervention/treatment
Cognitive impairment
Geriatric patients with a cognitive impairment
Other: Medical File consultation
Medical File consultation




Primary Outcome Measures :
  1. Therapeutic code [ Time Frame: From 01-01-2016 till 31-12-2016 ]
    Therapeutic code

  2. Cumulative Illness Rating Scale for Geriatrics [ Time Frame: From 01-01-2016 till 31-12-2016 ]
    This scoring system measures the chronic medical illness ("morbidity") burden while taking into consideration the severity of chronic diseases in 14 items representing individual body systems. The cumulative final score can theoretically vary from 0 to 56.


Secondary Outcome Measures :
  1. Age [ Time Frame: From 01-01-2016 till 31-12-2016 ]
    Age

  2. Sex [ Time Frame: From 01-01-2016 till 31-12-2016 ]
    Sex

  3. Ethnicity [ Time Frame: From 01-01-2016 till 31-12-2016 ]
    Ethnicity



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Ages Eligible for Study:   65 Years and older   (Older Adult)
Sexes Eligible for Study:   All
Sampling Method:   Non-Probability Sample
Study Population
Eldelry patients with cognitive imparement admitted in the geriatric unit 83 within the CHU Brugmann between 01-01-2016 and 31-12-2016.
Criteria

Inclusion Criteria:

Elderly patients with cognitive impairment admitted in the geriatric unit 83 within the CHU Brugmann between 01-01-2016 and 31-12-2016.

Exclusion Criteria:


Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03408028


Locations
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Belgium
CHU Brugmann
Brussels, Belgium
Sponsors and Collaborators
Murielle Surquin
Investigators
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Principal Investigator: Carolina Natalia Grande Pérez, MD CHU Brugmann

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Responsible Party: Murielle Surquin, Head of Clinic, Brugmann University Hospital
ClinicalTrials.gov Identifier: NCT03408028     History of Changes
Other Study ID Numbers: CHUB- status code
First Posted: January 23, 2018    Key Record Dates
Last Update Posted: January 23, 2018
Last Verified: January 2018
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Murielle Surquin, Brugmann University Hospital:
Therapeutic code
Geriatry

Additional relevant MeSH terms:
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Cognitive Dysfunction
Cognition Disorders
Neurocognitive Disorders
Mental Disorders