The primary objective in this study is to achieve a 15% 6-month improvement in therapeutic adherence among patients with chronic pathologies, thanks to a simple, standardized and redundant message delivered by healthcare professionals during consultations/interviews Trained healthcare professionals deliver a simple, standardized and redundant 3-point message to patients, based on the levers of action concerning therapeutic adherence. This message is delivered with the aim of modifying the patient's behavior with regard to treatment intake.
This project will enable us to adapt or even modify the practices of healthcare professionals, by making management recommendations to improve patients' adherence to treatment during their consultations/interviews, and throughout their entire course of care. This project will increase the benefit/risk ratio of treatments and reduce the waste of healthcare resources. For patients, their participation by filling in the therapeutic adherence self-questionnaire will enable them to become active players in the management of their treatment. If the results of our study prove positive, this will lead to a new, optimized organization of patient care.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE
Enrollment
1,210
This message is delivered with the aim of modifying the patient's behavior with regard to treatment intake. The research does not anticipate any change in the patient's medical prescriptions.
CHU d'Angers
Angers, France, France
CH d'Antibes
Antibes, France, France
Hôpital Corentin Celton
Issy-les-Moulineaux, France, France
Hôpital de la Conception
Marseille, France, France
Hôpital La Timone
Marseille, France, France
CHU de Nantes
Nantes, France, France
Hôpital européen Georges-Pompidou
Paris, France, France
Hôpital Bicêtre
Paris, France, France
CHU de Toulouse
Toulouse, France, France
CHU de Tours
Tours, France, France
Improvement in therapeutic adherence
The medication possession ratio (MPR), calculated as the ratio between the sum of treatment days delivered over the period of interest x 100, expressed as a %. In the literature, an MPR ≥ 80% corresponds to good therapeutic adherence.
Time frame: 6 months
Improvement in therapeutic adherence
The medication possession ratio (MPR), calculated as the ratio between the sum of treatment days delivered over the period of interest x 100, expressed as a %.
Time frame: 12 months
Predictive factors of improved adherence factors predictive of therapeutic adherence
Identification of predictive factors for improving adherence assessed by the Freedom patient self-questionnaire and known factors.
Time frame: 6 months
Improvement in therapeutic adherence estimated
patient adherence self-questionnaire, taking into account what the patient says between M0 and M3, M3 and M6; and between M0 and M12, M6 and M12 (11 questions formulated using a 5-point Likert scale), which classifies patients' therapeutic adherence into 3 classes: "low therapeutic adherence / average / high". Improvement in adherence will be assessed by changing the adherence category.
Time frame: 12 months
Costs of care according to periods (control vs. intervention)
The number of consultations (general practitioner, specialist, nurse), hospital admissions (day and conventional), emergency room visits, and the number and duration of days off work will be collected prospectively via a questionnaire on the evaluation of healthcare use given to the patient at M0, M3, M6 and M12. Costs will then be evaluated using the official tariffs for each procedure or hospitalization. Treatment costs will be evaluated on the basis of data from copies of prescriptions collected by pharmacists at each center.
Time frame: 12 months
Cost of the intervention
a comparison of the cost of the intervention in terms of time spent on training by healthcare professionals and delivery of the 3-point message for each patient will be carried out, compared with the control group.
Time frame: 12 months
Satisfaction of participating healthcare professionals and reasons for refusal to participate
Numbers and percentages will be reported for each question of the professional satisfaction self-questionnaire adapted from Jean-Marc Palm questionnaire. The questionnaire contains six questions. The answers range from totally disagree to totally agree.
Time frame: 12 months
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