ABSTRACT
Mobile geriatric team making home visit (MGT) were created to reinforce the link between home and hospital. Frail elderly patients can benefit from a comprehensive geriatric assessment (CGA) by a geriatric mobile team during a home visit. MGT at the hospital center of Lyon Sud presents recommendations after a CGA to better adjust healthcare to patients' needs. There are few studies that have analysed the MGT who treat patients at home. Objectives: The goal of the study was to determine adherence rate at 2 months and examines the socio-demographic profile of patients assessed by the MGT. We conducted a descriptive and retrospective study in single center, with 500 patients during 2 years (2016-2017). Results: The mean adherence rate was 65,1%. The highest rate concerned recommendations on the future orientation. The lower rate concerned recommendations on lifestyle and environment. Mean age of the 500 patients was 83.5 years, 61% were women. The patients included in this study take an average of seven prescription medications (whitout psychotropic medications). The majority of the patients was GIR 3 and achieved an average score of 3 on ADL scale and 2 of IADL scale. Ninety-six per cent of the patients had a caregiver. It has been proven statistically that, adherence rate of recommendations (more than 65%), reduce unplanned hospitalizations. Conclusion: This study with a large sample of patients allows to better describe patients seen at home. It is a vulnerable population presenting a polypathology, dependence, associated with an unstable socio-family context. This work shows that the recommendations must be applied to limit hospitalizations and that the involvement of the team makes it possible to improve the follow-up of the recommendations.
L'unité mobile extrahospitalière de gériatrie de Lyon-Sud propose une expertise gériatrique pluridisciplinaire au domicile des patients. Elle émet des recommandations pour rationaliser le parcours du sujet âgé en fonction de ses problématiques. L'objectif principal était de déterminer le taux de suivi à 2 mois des recommandations, et l'objectif secondaire de décrire le profil des patients suivis. Cette étude a inclus 500 patients sur 2 ans et a analysé 1 677 recommandations. Le taux de suivi global était de 65,1 %. Les patients avaient un âge médian de 83,5 ans, 61 % étaient des femmes et 88 % avaient un GIR ≤ 4. L'application des recommandations permet une diminution des hospitalisations non programmées. L'implication de l'équipe à l'issue de la visite optimise la mi%se en Åuvre de ces recommandations. Le grand effectif de cette étude permet de mieux décrire les patients vus à domicile : une population vulnérable présentant une polypathologie, dépendance, associés à un contexte socio-familial instable. Ce travail montre que les recommandations doivent être appliquées pour limiter les hospitalisations et que l'implication de l'équipe permet d'améliorer le suivi des préconisations.
