JMIR Publications

ABSTRACT

Background:

In France, emergency departments (EDs) are the fastest and most common means for GPs to cope with the complex issues presented by elderly patients with multiple conditions. Yet, as well as these services clearly being swamped, studies show that being treated in emergency departments can have a damaging effect on the health of elderly patients. Outpatient care or planned hospitalizations are possible solutions, as long as appropriate geriatric medical advice is provided. In 2013, France’s regional health authorities (RHAs) proposed creating direct telephone helplines, named geriatric hotlines, staffed by geriatric specialists to encourage interactions between GP clinics and hospitals. These hotlines are designed to improve the healthcare pathways and condition of the elderly.

Objective:

This study is aimed to describe the healthcare pathways and conditions of patients over 75 years of age, hospitalized in short-stay geriatric wards following referral from a geriatric hotline.

Methods:

The study will be conducted over 24 months in seven French university hospital centers. It will include all patients aged 75 and over, living in their own homes or in nursing homes, admitted to short-stay geriatric wards following hotline consultation. Two questionnaires will be filled out by medical staff at specific time points: one after conducting the telephone consultation, the other on admitting the patient to short-stay geriatric medical care. The primary endpoint will be the mean hospitalization duration. The secondary endpoints will be intra-hospital mortality rate, the characteristics of patients admitted via the hotline, and the types of questions asked and responses given via the Hotline.

Results:

The study was funded by the National School for Social Security Loire department (École Nationale Supérieure de Sécurité Sociale (En3s)) and the Conference for funders of prevention of autonomy loss for the elderly (CFPPA) of the Loire department in Novembre 2017, obtained institutional review board approval in April 2018. Data collection started in May 2018 and the planned end date for data is May 2020. Data analysis will take place in the summer of 2020 and the first results are expected to be published in late 2020.

Conclusions:

The results will reveal whether geriatric hotlines provide the most effective management of elderly patients, likely indicated by shorter mean hospitalization duration (MHD). This shorter MHD could lead to reduced risk of complications, geriatric syndromes, and therefore also that of domino chains of geriatric conditions. We will also describe different geriatric hotlines and compare how they function, in order to improve the health care of the elderly and pave the way toward new advances. Clinical Trial: Registered with Clinical Trial: NCT03959475 (Registered retrospectively 24 May 2019) and ANSM: ID RCB: 2018-A00609-46 (Registered 22 Februar 2018). This study was approved and peer-review by the Committee for the protection of persons and is registered, 2 May 2018, under reference 18-CETA-01 N°ID RCB 2018-A00609-46.