It is a randomized, controlled, open-label, parallel group study of 3 arms, among patients followed for chronic HIV infection at Cayenne hospital. The main objective of the study is to evaluate the effectiveness of follow-up of these patients by teleconsultation associated or not with health mediation.
The COVID-19 pandemic crisis has strained health systems, and chronic disease monitoring has often been put on hold, without yet really measuring the resulting health impact. In this context, e-Health has benefited from considerable momentum to overcome the shortcomings that have arisen, to allow remote monitoring of patients infected with COVID 19, to protect patients and caregivers and avoid nosocomial infections. Telemedicine is all the more relevant in Guyana as there are issues of geographic isolation, lack of specialists and critical mass of health professionals. In French Guiana, faced with the arrival of teleconsultation tools, a fear of professionals is their applicability for the most vulnerable populations, not knowing how to read or speak French and having restricted access to digital technology. Moreover HIV infection is an ever stigmatizing infection affecting populations that are often extremely precarious, requiring specialist monitoring and lifelong treatment. The study team propose to carry out a randomized, controlled, open-label, parallel group study of 3 arms, among patients followed for chronic HIV infection at Cayenne hospital : 1/ Control group with classic follow-up at Cayenne hospital. 2/Teleconsultation only group: patients referred to the remote monitoring platform without specific support. 3/Teleconsulation group + mediator: patients referred to the remote monitoring platform with support from a health mediator Patients will be followed every 3 months or 6 months depending on the judgment of the investigating physician for 12 months in the study (primary endpoint evaluated at 1 year). Number of patients to be included: 450 patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
DOUBLE
Enrollment
450
Patients are randomized into groups in which there are either teleconsultations alone or with the help of a mediator to carry out their follow-up care
General Hospital of Cayenne
Cayenne, French Guiana
RECRUITINGComparison of the proportions of patients who followed the schedule proposed by the physician at inclusion (or revised during important events) in the 3 arms.
Time frame: The inclusion period (1 year)
Identification of the best strategy for implementing an e-Health platform in French Guiana in the management of chronic HIV infection
Time frame: The inclusion period (1 year)
The proportion of patients throughout the inclusion period (1 year) likely to use the platform will be assessed using the number of patients meeting the inclusion criteria (having agreed to participate in the research or not).
Time frame: The inclusion period (1 year)
The obstacles to the use of an e-health platform will be evaluated using a questionnaire for caregivers and patients and based on the number of failed connections
Time frame: The inclusion period (1 year)
Patient satisfaction score assessed with study specific questionnaire
Time frame: The inclusion period (1 year)
Caregiver satisfaction score assessed with study specific questionnaire
Time frame: The inclusion period (1 year)
Evaluation of the material needs to guarantee accessibility of the consultation places
Time frame: The inclusion period (1 year)
Evaluation of the material needs for the implementation and maintenance of the e-health platform
Time frame: The inclusion period (1 year)
Measurement of the average intervention time of the doctors per patient
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Time frame: The inclusion period (1 year)
Measurement of the average intervention time of the mediators per patient
Time frame: The inclusion period (1 year)
Measurement of the average intervention time of the ETP nurse per patient
Time frame: The inclusion period (1 year)
Compare the patients followed up with the platform and the patients followed up in classic consultation on: the proportion of check-ups done during the same duration of follow-up, the proportion of patients with an undetectable viral load, the proportion
Time frame: The inclusion period (1 year)
proportion of check-ups done during the same duration of follow-up between patients followed up with the platform and the patients followed up in classic consultation
Time frame: The inclusion period (1 year)
proportion of patients with an undetectable viral load between patients followed up with the platform and the patients followed up in classic consultation
Time frame: The inclusion period (1 year)
Questionnaire for all the care providers assessed with study specific questionnaire
In order to evaluate the number of patients lost to follow-up, service congestion, patient waiting time, knowledge of the patient's pathway, communication with the patient, the number of missed consultations and the viral load of patients followed via the platform.
Time frame: The inclusion period (1 year)