Etude de la vaccination COVID chez les patients d'oncogeriatrie en hopital de jour

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Feedback from telehealth in the pharmacy: Reflections for the improvement and adaptation of pharmaceutical professional practices

Introduction: The COVID-19 health crisis precipitated the use of telehealth. To ensure continuity of care, during this period, pharmacists had the opportunity to use telecare and to offer teleconsultations with a physician to their patients. We report here on telehealth practices in a local pharmacy participating in the activities of a multidisciplinary health center (MSP). Material and methods: After analyzing a situation, the pharmacists of this dispensary offered teleconsultation or telecare to the patients. The doctors solicited were those from the MSP, those from the territory and those from a teleconsultation platform. Digital tools have enabled communication between doctors, patients and pharmacists on the one hand and enabled the pharmacist to assist the doctor during the teleconsultation, while ensuring the confidentiality and protection of patient data. Results: Thirteen teleconsultations and 22 telepharmacy consultations were performed. Four types of situations motivated the triggering of pharmacist-assisted teleconsultations and three of pharmaceutical telecare. The implementation of telehealth in this pharmacy required changes in the organization and management of the pharmacy, training of the pharmacy team, and closer communication with the MSP physicians. Discussion: Telehealth offers major opportunities for the evolution of the pharmacist's profession and the improvement of patient care, beyond crisis situations. © 2021 Elsevier Masson SAS

Retour d’expérience de télésanté à l’officine : réflexions pour l’amélioration et l’adaptation des pratiques professionnelles pharmaceutiques

Résumé Introduction La crise sanitaire liée au COVID-19 a précipité le recours à la télésanté. Pour assurer la continuité des soins durant cette période, les pharmaciens d’officine ont eu l’opportunité de recourir au télésoin et de proposer des téléconsultations avec un médecin à leurs patients. Nous établissons ici un bilan des pratiques de télésanté menées à cette occasion dans une officine de quartier, participant aux activités d’une maison de santé pluridisciplinaire multisite (MSP). Matériel et méthodes Après analyse de situation, les pharmaciens de cette officine ont proposé aux patients concernés soit une téléconsultation, soit un télésoin. Les médecins sollicités ont été ceux de la MSP, ceux du territoire et ceux d’une plate-forme de téléconsultation. Des outils numériques ont permis, d’une part, la communication entre médecins, patients et pharmaciens, et d’autre part, ont permis au pharmacien d’assister le médecin lors de la téléconsultation, tout en garantissant la confidentialité et la protection des données relatives aux patients. Résultats Treize téléconsultations et 22 télésoins pharmaceutiques ont été réalisés. Quatre types de situations ont motivé le déclenchement de téléconsultations assistées par le pharmacien et trois celui d’un télésoin pharmaceutique. La mise en œuvre de la télésanté dans cette officine a nécessité des modifications au niveau de l’organisation et du management au sein de l’officine, la formation de l’équipe officinale ainsi qu’une communication plus étroite avec les médecins de la MSP. Discussion La télésanté porte des ouvertures majeures pour l’évolution du métier de pharmacien et l’amélioration de la prise en charge des patients, au-delà des situations de crise. Summary Introduction The COVID-19 health crisis precipitated the use of telehealth. To ensure continuity of care, during this period, pharmacists had the opportunity to use telecare and to offer teleconsultations with a physician to their patients. We report here on telehealth practices in a local pharmacy participating in the activities of a multidisciplinary health center (MSP). Material and methods After analyzing a situation, the pharmacists of this dispensary offered teleconsultation or telecare to the patients. The doctors solicited were those from the MSP, those from the territory and those from a teleconsultation platform. Digital tools have enabled communication between doctors, patients and pharmacists on the one hand and enabled the pharmacist to assist the doctor during the teleconsultation, while ensuring the confidentiality and protection of patient data. Results Thirteen teleconsultations and 22 telepharmacy consultations were performed. Four types of situations motivated the triggering of pharmacist-assisted teleconsultations and three of pharmaceutical telecare. The implementation of telehealth in this pharmacy required changes in the organization and management of the pharmacy, training of the pharmacy team, and closer communication with the MSP physicians. Discussion Telehealth offers major opportunities for the evolution of the pharmacist's profession and the improvement of patient care, beyond crisis situations.

Centenarians in nursing homes during the COVID-19 pandemic

BACKGROUND: Centenarians are known to be successful agers compared to other older adults. OBJECTIVE: The objective of the present study was to compare coronavirus disease (COVID-19) symptoms and outcomes in centenarians and other residents living in nursing homes. Design-Setting-Subjects-Methods: A retrospective multicenter cohort study was conducted using data from 15 nursing homes in the Marseille area. Older residents with confirmed COVID-19 between March and June 2020 were enrolled. The clinical and biological characteristics, the treatment measures, and the outcomes in residents living in these nursing homes were collected from the medical records. RESULTS: A total of 321 residents were diagnosed with COVID-19 including 12 centenarians. The median age was 101 years in centenarians and 89 years in other residents. The most common symptoms were asthenia and fever. Three centenarians (25%) experienced a worsening of pre-existing depression (vs. 5.5% of younger residents;p = 0.032). Mortality was significantly higher in centenarians than in younger residents (50% vs. 21.3%, respectively;p = 0.031). A quarter of the younger residents and only one centenarian were hospitalized. However, 33.3% of the centenarians received treatment within the context of home hospitalization. CONCLUSION: Worsening of pre-existing depression seems to be more frequent in centenarians with COVID-19 in nursing homes. This population had a higher mortality rate but a lower hospitalization rate than younger residents.