Therapeutic Intervention Code in a Cognitive Geriatric Unit

January 17, 2018 updated by: Murielle Surquin

Therapeutic Intervention Code in a Cognitive Geriatric Unit: Retrospective Analysis

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

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Observational

Enrollment (Actual)

310

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Brussels, Belgium
        • CHU Brugmann

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

61 years and older (Older Adult)

Accepts Healthy Volunteers

N/A

Genders 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.

Description

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:

None

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Observational Models: Cohort
  • Time Perspectives: Retrospective

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Cognitive impairment
Geriatric patients with a cognitive impairment
Medical File consultation

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Therapeutic code
Time Frame: From 01-01-2016 till 31-12-2016
Therapeutic code
From 01-01-2016 till 31-12-2016
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.
From 01-01-2016 till 31-12-2016

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Age
Time Frame: From 01-01-2016 till 31-12-2016
Age
From 01-01-2016 till 31-12-2016
Sex
Time Frame: From 01-01-2016 till 31-12-2016
Sex
From 01-01-2016 till 31-12-2016
Ethnicity
Time Frame: From 01-01-2016 till 31-12-2016
Ethnicity
From 01-01-2016 till 31-12-2016

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Principal Investigator: Carolina Natalia Grande Pérez, MD, CHU Brugmann

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

April 1, 2017

Primary Completion (Actual)

October 1, 2017

Study Completion (Actual)

October 1, 2017

Study Registration Dates

First Submitted

January 17, 2018

First Submitted That Met QC Criteria

January 17, 2018

First Posted (Actual)

January 23, 2018

Study Record Updates

Last Update Posted (Actual)

January 23, 2018

Last Update Submitted That Met QC Criteria

January 17, 2018

Last Verified

January 1, 2018

More Information

Terms related to this study

Other Study ID Numbers

  • CHUB- status code

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

No

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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