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
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...
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BMJ Publishing Group
2022-07-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/7/e059464.full |
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| author | Bruno Giraudeau Estelle Boivin Vincent Camus Agnes Caille Olivier Saint-Lary Jean-Pierre Lebeau Stéphanie Sidorkiewicz Denis Pouchain Maeva Jego Sophie Sun Denis Angoulvant Wissam El-Hage Sébastien Bruel Clarisse Dibao-Dina Julie Léger Isabelle Ettori-Ajasse Juliette Chambe Karim Abou-Mrad-Fricquegnon Baptiste Motte Benoit Chiron Cam-Anh Khau Tiphanie Bouchez Maria Ghali Leslie Guillon-Grammatico Emeline Laurent Rémy Boussageon |
| author_facet | Bruno Giraudeau Estelle Boivin Vincent Camus Agnes Caille Olivier Saint-Lary Jean-Pierre Lebeau Stéphanie Sidorkiewicz Denis Pouchain Maeva Jego Sophie Sun Denis Angoulvant Wissam El-Hage Sébastien Bruel Clarisse Dibao-Dina Julie Léger Isabelle Ettori-Ajasse Juliette Chambe Karim Abou-Mrad-Fricquegnon Baptiste Motte Benoit Chiron Cam-Anh Khau Tiphanie Bouchez Maria Ghali Leslie Guillon-Grammatico Emeline Laurent Rémy Boussageon |
| author_sort | Bruno Giraudeau |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-3cf292718a6d4d8cb004beb4c055ec9b |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-3cf292718a6d4d8cb004beb4c055ec9b2025-01-30T19:10:14ZengBMJ Publishing GroupBMJ Open2044-60552022-07-0112710.1136/bmjopen-2021-059464Impact 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 trialBruno Giraudeau0Estelle Boivin1Vincent Camus2Agnes Caille3Olivier Saint-Lary4Jean-Pierre Lebeau5Stéphanie Sidorkiewicz6Denis Pouchain7Maeva Jego8Sophie Sun9Denis Angoulvant10Wissam El-Hage11Sébastien Bruel12Clarisse Dibao-Dina13Julie Léger14Isabelle Ettori-Ajasse15Juliette Chambe16Karim Abou-Mrad-Fricquegnon17Baptiste Motte18Benoit Chiron19Cam-Anh Khau20Tiphanie Bouchez21Maria Ghali22Leslie Guillon-Grammatico23Emeline Laurent24Rémy Boussageon25University of Tours, University of Nantes, INSERM SPHERE U1246, Tours, FranceCIC Tours, CHRU Tours, Tours, FranceCHRU Tours, Tours, FranceINSERM U1246, Tours, FranceResearch, French National College of Teachers in General Practice, Paris, FranceDepartment of General Practice, University of Tours, Tours, FranceDepartment of General Practice, Hôpital Hôtel-Dieu, Sorbonne Paris Cité, Paris Descartes University, Paris, FranceDepartment of General Practice, University of Tours, Tours, FranceDepartment of General Practice, Aix-Marseille University, Marseille, FranceCUMG, Universite Lyon 1 Faculte de Medecine Lyon-Est, Lyon, FranceEA4245 T2i, Tours, FranceCHRU Tours, Tours, FranceDepartment of General Practice, Faculty Jacques Lisfranc, Jean Monnet University Medical, Saint Priest en Jarez, France5 Department of General Medicine, University of Tours, Tours, Centre-Val de Loire, FranceCIC Tours, CHRU Tours, Tours, FranceDepartment of General Practice, University of Tours, Tours, FranceDepartment of General Practice, University of Strasbourg, Strasbourg, FranceDepartment of General Practice, University of Tours, Tours, FranceDepartment of General Practice, University of Lille, Lille, FranceDepartment of General Practice, Bretagne Occidentale University, Brest, FranceDepartment of Medicine, University of Paris, Paris, FranceDepartment of General Practice, University of Nice Sophia Antipolis, Nice, FranceDepartment of General Practice, University of Angers, Angers, FranceCHRU Tours, Tours, France1 Epidemiology Unit for Clinical Data in Centre-Val de Loire (EpiDcliC), CHRU de Tours, Tours, Centre-Val de Loire, FranceUCBL, CNRS, UMR 5558, LBBE, EMET, University Claude Bernard Lyon 1, Villeurbanne, FranceObjectives 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.https://bmjopen.bmj.com/content/12/7/e059464.full |
| spellingShingle | Bruno Giraudeau Estelle Boivin Vincent Camus Agnes Caille Olivier Saint-Lary Jean-Pierre Lebeau Stéphanie Sidorkiewicz Denis Pouchain Maeva Jego Sophie Sun Denis Angoulvant Wissam El-Hage Sébastien Bruel Clarisse Dibao-Dina Julie Léger Isabelle Ettori-Ajasse Juliette Chambe Karim Abou-Mrad-Fricquegnon Baptiste Motte Benoit Chiron Cam-Anh Khau Tiphanie Bouchez Maria Ghali Leslie Guillon-Grammatico Emeline Laurent Rémy Boussageon 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 BMJ Open |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| url | https://bmjopen.bmj.com/content/12/7/e059464.full |
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