Impact of a phone call with a medical student/general practitioner team on morbidity of chronic patients during the first French COVID-19 lockdown (COVIQuest): a cluster randomised trial.

Autor:	Dibao-Dina C; Department of General Practice, University of Tours, Tours, France clarisse.dibao-dina@univ-tours.fr.; INSERM U1246, Tours, France.; Research, French National College of Teachers in General Practice, Paris, France., Léger J; CIC Tours, CHRU Tours, Tours, France., Ettori-Ajasse I; Department of General Practice, University of Tours, Tours, France.; EA 7505 EES, Tours, France., Boivin E; CIC Tours, CHRU Tours, Tours, France., Chambe J; Department of General Practice, University of Strasbourg, Strasbourg, France., Abou-Mrad-Fricquegnon K; Department of General Practice, University of Tours, Tours, France., Sun S; CUMG, Universite Lyon 1 Faculte de Medecine Lyon-Est, Lyon, France., Jego M; Department of General Practice, Aix-Marseille University, Marseille, France.; CEReSS - Health Services Research and Quality of life Center, Marseille, France., Motte B; Department of General Practice, University of Lille, Lille, France., Chiron B; Department of General Practice, Bretagne Occidentale University, Brest, France., Sidorkiewicz S; Department of General Practice, Hôpital Hôtel-Dieu, Sorbonne Paris Cité, Paris Descartes University, Paris, France., Khau CA; Department of Medicine, University of Paris, Paris, France., Bouchez T; Department of General Practice, University of Nice Sophia Antipolis, Nice, France., Ghali M; Department of General Practice, University of Angers, Angers, France., Bruel S; Department of General Practice, Faculty Jacques Lisfranc, Jean Monnet University Medical, Saint Priest en Jarez, France., Lebeau JP; Department of General Practice, University of Tours, Tours, France.; Research, French National College of Teachers in General Practice, Paris, France.; EA 7505 EES, Tours, France., Camus V; CHRU Tours, Tours, France., El-Hage W; CHRU Tours, Tours, France.; INSERM UMR 1253, Tours, France., Angoulvant D; CHRU Tours, Tours, France.; EA4245 T2i, Tours, France., Caille A; INSERM U1246, Tours, France.; CIC Tours, CHRU Tours, Tours, France., Guillon-Grammatico L; CHRU Tours, Tours, France., Laurent E; CHRU Tours, Tours, France., Saint-Lary O; Research, French National College of Teachers in General Practice, Paris, France.; Department of General Practice, Paris-Saclay University, Saint-Aubin, France., Boussageon R; Research, French National College of Teachers in General Practice, Paris, France.; Department of General Medicine, Université de Poitiers, Poitiers, France., Pouchain D; Department of General Practice, University of Tours, Tours, France.; Research, French National College of Teachers in General Practice, Paris, France., Giraudeau B; INSERM U1246, Tours, France.; CIC Tours, CHRU Tours, Tours, France.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2022 Jul 28; Vol. 12 (7), pp. e059464. Date of Electronic Publication: 2022 Jul 28.
DOI:	10.1136/bmjopen-2021-059464
Abstrakt:	Objectives: The first COVID-19 lockdown led to a significantly reduced access to healthcare, which may have increased decompensations in frail patients with chronic diseases, especially older patients living with a chronic cardiovascular disease (CVD) or a mental health disorder (MHD). The objective of COVIQuest was to evaluate whether a general practitioner (GP)-initiated phone call to patients with CVD and MHD during the COVID-19 lockdown could reduce the number of hospitalisation(s) over a 1-month period. Design: This is a cluster randomised controlled trial. Clusters were GPs from eight French regions. Participants: Patients ≥70 years old with chronic CVD (COVIQuest_CV subtrial) or ≥18 years old with MHD (COVIQuest_MH subtrial). Interventions: A standardised GP-initiated phone call aiming to evaluate patients' need for urgent healthcare, with a control group benefiting from usual care (ie, the contact with the GP was by the patient's initiative). Main Outcome Measures: Hospital admission within 1 month after the phone call. Results: In the COVIQuest_CV subtrial, 131 GPs and 1834 patients were included in the intervention group and 136 GPs and 1510 patients were allocated to the control group. Overall, 65 (3.54%) patients were hospitalised in the intervention group vs 69 (4.57%) in the control group (OR 0.82, 95% CI 0.56 to 1.20; risk difference -0.77, 95% CI -2.28 to 0.74). In the COVIQuest_MH subtrial, 136 GPs and 832 patients were included in the intervention group and 131 GPs and 548 patients were allocated to the control group. Overall, 27 (3.25%) patients were hospitalised in the intervention group vs 12 (2.19%) in the control group (OR 1.52, 95% CI 0.82 to 2.81; risk difference 1.38, 95% CI 0.06 to 2.70). Conclusion: A GP-initiated phone call may have been associated with more hospitalisations within 1 month for patients with MHD, but results lack robustness and significance depending on the statistical approach used. Trial Registration Number: NCT04359875. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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