Impact of a Procedure for the Information and Active Participation of the Patient in the Primary Care Prescription of Antihypertensives (InPAct)
22 janvier 2015 mis à jour par: Hospices Civils de Lyon
Impact of a Procedure for the Information and Active Participation of the Patient in the Primary Care Prescription of Antihypertensives : InPAct Study (Information for Participating Actively in Cardiovascular Treatment)
Adverse drug events (ADEs) are responsible for 3.6% of the hospitalisations in France.
50% of these ADEs could be preventable.
Cardiovascular drugs are frequently involved in ADEs.
A common underlying factor of such events is inadequate communication between patients and medical personnel.
General practitioners (GP) often initiate the treatment of hypertension, being generally the first prescribers of these medications.
12.6% of the patients present an ADE with hypertensive drug after 3 months.
The InPAct procedure is a tool to facilitate communication in order to improve patient safety in primary care.
In the context of the primary care prescription of an antihypertensive drug, the GP informs the patient about hypertension, cardiovascular risk, and the benefits and risks of antihypertensive drugs, which helps the patient to detect and declare situations involving a heightened risk of antihypertensive-related ADEs.
The aim of the InPAct study is to evaluate the efficiency of the InPAct intervention in primary care.
Aperçu de l'étude
Statut
Complété
Les conditions
Intervention / Traitement
Description détaillée
A stepped wedge cluster randomized study, with 8 clusters and 5 periods of 3 months each.
Each cluster is composed of about ten general practitioners.
The InPAct intervention will not be presented to the first patients recruited by each general practitioner, whereas it will be presented to all their last patients.
The period of intervention introduction by each general practitioner will be randomized amongst the 5 periods.
Type d'étude
Observationnel
Inscription (Réel)
1100
Contacts et emplacements
Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.
Lieux d'étude
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Lyon, France, 69003
- Hospices Civils de Lyon
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Critères de participation
Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.
Critère d'éligibilité
Âges éligibles pour étudier
18 ans et plus (Adulte, Adulte plus âgé)
Accepte les volontaires sains
Non
Sexes éligibles pour l'étude
Tout
Méthode d'échantillonnage
Échantillon non probabiliste
Population étudiée
Hypertensive patients on anti-hypertensive medication.
Patients of 85 general practitioners selected in Rhone-Alps/Auvergne and Paris region in France.
La description
Inclusion Criteria:
- Patient monitored for essential hypertension requiring a first prescription, a renewal or a change of antihypertensive drug treatment
- Patient with the ability to understand and express themselves in French
- Patient accepting to communicate his phone number and accepting a telephone survey within the fourth month following its inclusion in the study.
Exclusion Criteria :
- Patient with a psychiatric disorder or a progressive dementia.
- Patient with hypertension in pregnancy or secondary hypertension.
- Patient with an acute hypertensive crisis.
- Patient under guardianship.
- Patient who is likely to move or may have an irregular follow up within 6 months following its inclusion in the study.
Plan d'étude
Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.
Comment l'étude est-elle conçue ?
Détails de conception
- Perspectives temporelles: Éventuel
Cohortes et interventions
Groupe / Cohorte |
Intervention / Traitement |
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Patients with the InPAct intervention
The InPAct intervention will be presented to the last patients recruited by each general practitioner
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Educational guide presented by general practitioners to the patients.
A first part of the guide contains some information on cardiovascular risk and on the benefits and risks of antihypertensive drugs.
A second part of the guide consists of encouraging the patient to take an active part in monitoring of its treatment.
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Patients without the InPAct intervention
The InPAct intervention will not be presented to the first patients recruited by each general practitioner
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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The proportion of patients on antihypertensive drug reporting themselves at least one Adverse Drug Event (ADE) to their general practitioner during their 90 days of follow up.
Délai: During the study : 19 months
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Symptoms could have begun before patient inclusion in the study, but symptoms have to be related to an ADE and reported during the 90 days of patient follow up.
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During the study : 19 months
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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The proportion of patients on antihypertensive drug with at least an ADE detected (reported by the patient himself, or not) during their 90 days of follow up.
Délai: During the study : 19 months
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Symptoms could have begun before patient inclusion in the study, but symptoms have to be related to an ADE during the 90 days of patient follow up.
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During the study : 19 months
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The proportion of patients on antihypertensive drug presenting at least one situation of risk for ADE during the 90 days of patient follow up.
Délai: During the study : 19 months
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During the study : 19 months
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The proportion of patients on antihypertensive drug for whom a physician has changed or modified at least one prescription during the 90 days of patient follow up.
Délai: During the study : 19 months
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This modification had to be made following an ADE or a situation of risk for ADE associated with taking an anti-hypertensive drug or a drug associated with antihypertensive treatment.
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During the study : 19 months
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The proportion of patients who developed at least one complication following an ADE detected during the 90 days of patient follow up.
Délai: During the study : 19 months
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During the study : 19 months
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A mean score of patient satisfaction regarding the communication and information on drug prescription and management of hypertension by the general practitioner, during the 90 days of patient follow up.
Délai: During the study : 19 months
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During the study : 19 months
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A mean score of patient skill in health after 90 days of follow-up, including a score of patient knowledge on cardiovascular risk and on the benefits and risks of antihypertensive drugs, and a score of patient skill in situation of ADE.
Délai: During the study : 19 months
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During the study : 19 months
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Collaborateurs et enquêteurs
C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.
Parrainer
Les enquêteurs
- Chercheur principal: Cyrille COLIN, Hospices Civils de Lyon
Publications et liens utiles
La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.
Publications générales
- Buchet-Poyau K, Occelli P, Touzet S, Langlois-Jacques C, Figon S, Dubois JP, Duclos A, Chaneliere M, Colin C, Rabilloud M, Keriel-Gascou M. Improving patient self-reporting of antihypertensive adverse drug events in primary care: a stepped wedge cluster randomised trial. BMC Fam Pract. 2021 Aug 7;22(1):165. doi: 10.1186/s12875-021-01478-w.
- Keriel-Gascou M, Buchet-Poyau K, Duclos A, Rabilloud M, Figon S, Dubois JP, Brami J, Vial T, Colin C. Evaluation of an interactive program for preventing adverse drug events in primary care: study protocol of the InPAct cluster randomised stepped wedge trial. Implement Sci. 2013 Jun 19;8:69. doi: 10.1186/1748-5908-8-69.
Dates d'enregistrement des études
Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.
Dates principales de l'étude
Début de l'étude
1 mai 2012
Achèvement primaire (Réel)
1 décembre 2013
Achèvement de l'étude (Réel)
1 juin 2014
Dates d'inscription aux études
Première soumission
30 mai 2012
Première soumission répondant aux critères de contrôle qualité
1 juin 2012
Première publication (Estimation)
4 juin 2012
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Estimation)
26 janvier 2015
Dernière mise à jour soumise répondant aux critères de contrôle qualité
22 janvier 2015
Dernière vérification
1 janvier 2015
Plus d'information
Termes liés à cette étude
Mots clés
Autres numéros d'identification d'étude
- D50802
- PHRC National 2011 (Autre identifiant: government)
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