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Durlach O, Tripoz-Dit-Masson S, Massé-Deragon N, Subtil F, Niasse-Sy Z, Herledan C, Guittard L, Goldet K, Merazga S, Chabert M, Suel A, Dayde D, Merdinian M, Falandry C. Feasibility of a screening and prevention procedure for risks associated with dysphagia in older patients in geriatric units: the DYSPHAGING pilot study protocol. BMJ Open 2024; 14:e081333. [PMID: 38642998 PMCID: PMC11033636 DOI: 10.1136/bmjopen-2023-081333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 03/24/2024] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND Dysphagia, particularly sarcopenic dysphagia, is frequent in frail older patients. Sarcopenic dysphagia is a swallowing disorder caused by sarcopenia, corresponding to a loss of muscle mass and strength. It frequently leads to inhalation and to the decrease of food intake, leading the patient to enter a vicious circle of chronic malnutrition and frailty. The awareness of the major health impacts of sarcopenic dysphagia is recent, explaining a low rate of screening in the population at risk. In this context, methods of prevention, evaluation and intervention of sarcopenic dysphagia adapted to the most at-risk population are necessary. METHODS The DYSPHAGING (dysphagia & aging) pilot study is a prospective, multicentre, non-comparative study aiming to estimate the feasibility of an intervention on allied health professionals using the DYSPHAGING educational sheet designed to implement a two-step procedure 'screen-prevent' to mitigate swallowing disorders related to sarcopenic dysphagia. After obtaining oral consent, patients are screened using Eating Assessment Tool-10 Score. In case of a score≥2, procedures including positional manoeuvres during mealtimes, food and texture adaptation should be implemented. The primary endpoint of the study is the feasibility of this two-step procedure (screening-prevention measures) in the first 3 days after patient's consent.The study will include 102 patients, with an expected 10% rate of non-analysable patients. Participants will be recruited from acute geriatric wards, rehabilitation centres and long-term care units, with the hypothesis to reach a feasibility rate of 50% and reject a rate lower than 35%. ETHICS AND DISSEMINATION The study protocol was approved according to French legislation (CPP Ile-de-France VII) on 15 February 2023. The results of the primary and secondary objectives will be published in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT05734586.
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Affiliation(s)
- Olivier Durlach
- Institut du Vieillissement, Hospices Civils de Lyon, Lyon, Auvergne-Rhône-Alpes, France
| | - Stéphanie Tripoz-Dit-Masson
- Centre de Recherche Clinique Vieillissement, Cerveau, Fragilité, Hôpital des Charpennes, Hospices Civils de Lyon, Villeurbanne, Auvergne-Rhône-Alpes, France
| | - Nicolas Massé-Deragon
- Institut du Vieillissement, Hospices Civils de Lyon, Lyon, Auvergne-Rhône-Alpes, France
| | - Fabien Subtil
- CNRS, UMR5558, Laboratoire de Biométrie et Biologie Evolutive, Lyon, Universite Claude Bernard Lyon 1, Villeurbanne, Auvergne-Rhône-Alpes, France
- Service de Biostatistique, Hospices Civils de Lyon, Lyon, Auvergne-Rhône-Alpes, France
| | - Zeinabou Niasse-Sy
- Institut du Vieillissement, Hospices Civils de Lyon, Lyon, Auvergne-Rhône-Alpes, France
- Geriatrics, Université Lyon 1 Faculte de Medecine et de Maieutique Lyon-Sud Charles Merieux, Oullins, Rhône-Alpes, France
- Hospices Civils de Lyon, Lyon, Auvergne-Rhône-Alpes, France
| | - Chloé Herledan
- Unité de Pharmacie clinique oncologique, Hospices Civils de Lyon, Lyon, Auvergne-Rhône-Alpes, France
- EA 3738 CICLY, Université Claude Bernard Lyon 1, Villeurbanne, Auvergne-Rhône-Alpes, France
| | - Laure Guittard
- Pôle de Santé Publique, Service Recherche et Epidémiologie cliniques, Hospices Civils de Lyon, 69008 Lyon, France
- Research on Healthcare Performance (RESHAPE), Inserm U1290, Université Claude Bernard Lyon 1, 69008 Lyon, Auvergne-Rhône-Alpes, France
| | - Karine Goldet
- Centre de Recherche Clinique Vieillissement, Cerveau, Fragilité, Hôpital des Charpennes, Hospices Civils de Lyon, Villeurbanne, Auvergne-Rhône-Alpes, France
| | - Salima Merazga
- Direction à la Recherche en Santé, Hospices Civils de Lyon, Lyon, Auvergne-Rhône-Alpes, France
| | - Margaux Chabert
- Direction à la Recherche en Santé, Hospices Civils de Lyon, Lyon, Auvergne-Rhône-Alpes, France
| | - Anne Suel
- Direction à la Recherche en Santé, Hospices Civils de Lyon, Lyon, Auvergne-Rhône-Alpes, France
| | - David Dayde
- Plateforme Transversale de Recherche de l'ICHCL, Hospices Civils de Lyon, Lyon, Auvergne-Rhône-Alpes, France
| | - Marion Merdinian
- Institut du Vieillissement, Hospices Civils de Lyon, Lyon, Auvergne-Rhône-Alpes, France
- Service de Gériatrie, Groupement Hospitalier Sud, Hospices Civils de Lyon, Lyon, Auvergne-Rhône-Alpes, France
| | - Claire Falandry
- Institut du Vieillissement, Hospices Civils de Lyon, Lyon, Auvergne-Rhône-Alpes, France
- Service de Gériatrie, Centre Hospitalier de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
- CarMeN Laboratory, Inserm U1060, INRA U1397, Université Claude Bernard Lyon 1, INSA Lyon, Charles Mérieux Medical School, University of Lyon, Oullins, France
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Quillon A, Guittard L, Goldet K, Etienne M, Blond E, Nourredine M, Martin-Gaujard G, Doh S. A cross-sectional study to evaluate hypovitaminosis C prevalence and risk factors in an acute geriatric unit in Lyon, France: the HYPO-VIT-C protocol. BMJ Open 2023; 13:e075924. [PMID: 37612102 PMCID: PMC10450057 DOI: 10.1136/bmjopen-2023-075924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 08/07/2023] [Indexed: 08/25/2023] Open
Abstract
INTRODUCTION Vitamin C is an essential micronutrient playing crucial roles in human biology. Hypovitaminosis C is defined by a plasmatic ascorbemia below 23 µmol/L and is associated with numerous outcomes such as cardiovascular diseases, cancers or neurocognitive disorders. Numerous risk factors are common among older adults making them particularly susceptible to hypovitaminosis C. These risk factors include reduced vitamin intakes, higher vitamin metabolism related to polypathology, and iatrogeny because of polypharmacy. However, the precise prevalence of hypovitaminosis C and its risk factors are poorly documented within the geriatric population.A better knowledge of hypovitaminosis C prevalence and risk factor may lead to improving the vitamin C status among older people and prevent its consequences. METHOD AND ANALYSIS To answer these questions, we designed a monocentric cross-sectional study in a population of older hospitalised patients in Lyon, France. A sample size of 385 patients was needed to estimate hypovitaminosis C prevalence. The study was proposed to all eligible patient aged more than 75 years old entering the participating acute geriatric unit. The plasmatic vitamin C status was systematically assessed for participating patients, and variables part of the medical and geriatric evaluation were collected. For patients with severe vitamin C depletion, an oral supplementation and a follow-up phone call were organised to ensure treatment completion and tolerance. ETHICS AND DISSEMINATION The protocol has been approved by an independent national ethics committee and meets the methodological requirements. Final outcomes will be published in a peer-reviewed journal and disseminated through conferences. TRIAL REGISTRATION NUMBER NCT05668663.
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Affiliation(s)
- Alfred Quillon
- Service de médecine gériatrique, Hospices Civils de Lyon, Lyon, France
- Faculté de Médecine Lyon-Est, Université Lyon 1, Lyon, France
| | - Laure Guittard
- Pôle Santé Publique, Service Recherche et Epidémiologie cliniques, Hospices Civils de Lyon, Lyon, France
- Research on Healthcare Performance (RESHAPE), Inserm U1290, Université Claude Bernard Lyon 1, Lyon, France
| | - Karine Goldet
- Clinical Research Centre, Ageing, Brain, Fragility - Hôpital des Charpennes, Hospices Civils de Lyon, Villeurbanne, France
| | - Madeleine Etienne
- Clinical Research Centre, Ageing, Brain, Fragility - Hôpital des Charpennes, Hospices Civils de Lyon, Villeurbanne, France
| | - Emilie Blond
- Department of Biochemistry, Lyon Sud Hospital, Hospices Civils de Lyon, Pierre-Bénite, France
- CarMeN Laboratory - INSERM U1060, INRAE U1397, University Claude Bernard Lyon 1, Pierre-Bénite, France
| | - Mikail Nourredine
- Department of biostatistics, Hospices Civils de Lyon, Lyon, France
- Service hospitalo-universitaire de pharmacotoxicologie, Hospices Civils de Lyon, Lyon, France
- Laboratoire de biométrie et biologie évolutive, UMR CNRS 5558, Lyon, France
| | | | - Sébastien Doh
- Service de médecine gériatrique, Hospices Civils de Lyon, Lyon, France
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Schwartz A, Mere P, Subtil F, Labrosse H, Farsi F, Guittard L, Kim BA, Martin-Gaujard G, Lombard-Bohas C, Castel-Kremer E. RCP dédiée à l’onco-gériatrie : décisions et suivi à quatre mois. Bull Cancer 2022; 109:659-669. [DOI: 10.1016/j.bulcan.2022.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 01/17/2022] [Accepted: 01/17/2022] [Indexed: 10/18/2022]
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Fassier JB, Rouat S, Guittard L, Broc G, Carretier J, Peron J, Sarnin P, Fervers B, Letrilliart L, Lancelot L, Baka S, Bouché ML. Faciliter et soutenir le retour au travail après un cancer du sein : partenariat chercheurs-acteurs dans un processus de modélisation d’une intervention. Glob Health Promot 2021. [DOI: 10.1177/1757975921993358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction : La reprise du travail après un cancer favorise le rétablissement de la participation sociale mais se heurte à différents obstacles. Le projet FASTRACS vise à développer, implanter et évaluer une intervention pour faciliter le maintien en emploi après un cancer du sein. Le développement de l’intervention repose sur le protocole de l’Intervention Mapping. L’objectif de cet article est de décrire les contributions du partenariat chercheurs-acteurs dans le processus de modélisation de l’intervention durant les étapes du protocole de l’Intervention Mapping. Méthodes : Le processus de développement de l’intervention est reconstitué de façon chronologique en décrivant les méthodes mobilisées et les résultats obtenus à chaque étape du protocole grâce au partenariat chercheurs-acteurs. Résultats : Les membres du Comité stratégique (COS) ont été choisis par échantillonnage théorique parmi quatre catégories d’acteurs concernées. Une charte a été coécrite pour structurer durablement le partenariat. Les membres du COS ont contribué à l’échantillonnage des participants à l’enquête qualitative d’évaluation des besoins et à l’interprétation des résultats. Les objectifs de l’intervention ont été hiérarchisés selon leur importance et leur faisabilité perçues. Les chercheurs et membres du COS ont évalué les outils de l’intervention et débattu sur le modèle logique de l’intervention. Les professionnels de santé participant au COS ont facilité l’adhésion des équipes d’oncologie participant à l’intervention. Discussion : La construction du partenariat a permis de modifier les représentations des chercheurs. L’établissement de relations de confiance a nécessité du temps et de partager ses limites. Il a été difficile d’intégrer des patientes socialement défavorisées. Le recours accru à des patientes-expertes devrait être encouragé. Conclusion : La construction d’un partenariat de recherche collaborative entre chercheurs et acteurs nécessite du temps, des méthodes, et des financements dédiés. Cet investissement est de nature à améliorer la pertinence, l’acceptabilité, la légitimité et la pérennité des interventions développées.
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Affiliation(s)
- Jean-Baptiste Fassier
- Université Claude Bernard Lyon 1, Unité mixte de recherche épidémiologique et de surveillance transport travail environnement (UMRESTTE) UMR T9405, Lyon, Auvergne-Rhône-Alpes, France
| | - Sabrina Rouat
- Université Lumière Lyon 2, Groupe de recherche en psychologie sociale (GREPS) EA4163, Institut de Psychologie, Lyon, Auvergne-Rhône-Alpes, France
| | - Laure Guittard
- Université Claude Bernard Lyon 1 - Collège universitaire de médecine générale, Lyon, Auvergne-Rhône-Alpes, France
| | - Guillaume Broc
- Université Paul-Valéry Montpellier 3 Laboratoire Epsylon, Montpellier, Occitanie, France
| | - Julien Carretier
- Centre Léon Bérard, Département Cancer Environnement, Lyon, Auvergne-Rhône-Alpes, France
| | - Julien Peron
- Université Claude Bernard Lyon 1 - Collège universitaire de médecine générale, Lyon, Auvergne-Rhône-Alpes, France
| | - Philippe Sarnin
- Université Lumière Lyon 2, Groupe de recherche en psychologie sociale (GREPS) EA4163, Institut de Psychologie, Lyon, Auvergne-Rhône-Alpes, France
| | - Béatrice Fervers
- Centre Léon Bérard, Département Cancer Environnement, Lyon, Auvergne-Rhône-Alpes, France
| | - Laurent Letrilliart
- Université Claude Bernard Lyon 1 - Collège universitaire de médecine générale, Lyon, Auvergne-Rhône-Alpes, France
| | - Léa Lancelot
- Hospices Civils de Lyon, Service recherche et épidémiologie cliniques, pôle santé publique, Lyon, Auvergne-Rhône-Alpes, France
| | - Selma Baka
- Hospices Civils de Lyon, Service recherche et épidémiologie cliniques, pôle santé publique, Lyon, Auvergne-Rhône-Alpes, France
| | - Marion Lamort Bouché
- Université Claude Bernard Lyon 1 - Collège universitaire de médecine générale, Lyon, Auvergne-Rhône-Alpes, France
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Nguyen KA, Mimouni Y, Jaberi E, Paret N, Boussaha I, Vial T, Jacqz-Aigrain E, Alberti C, Guittard L, Remontet L, Roche L, Bossard N, Kassai B. Relationship between adverse drug reactions and unlicensed/off-label drug use in hospitalized children (EREMI): A study protocol. Therapie 2021; 76:675-685. [PMID: 33593598 DOI: 10.1016/j.therap.2021.01.057] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 11/18/2020] [Accepted: 01/28/2021] [Indexed: 01/15/2023]
Abstract
INTRODUCTION To date, few studies have shown a significant association between off-label drug use and adverse drug reactions (ADRs). The main aims of this study is to evaluate the relationship between adverse drug reactions and unlicensed or off-label drugs in hospitalized children and to provide more information on prescribing practice, the amplitude, consequences of unlicensed or off-label drug use in pediatric inpatients. METHODS In this multicenter prospective study started from 2013, we use the French summaries of product characteristics in Theriaque (a prescription products guide) as a primary reference source for determining pediatric drug labeling. The detection of ADRs is carried out spontaneously by health professionals and actively by research groups using a trigger tool and patients' electronic health records. The causality between suspected ADRs and medication is evaluated using the Naranjo and the French methods of imputability independently by pharmacovigilance center. All suspected ADRs are submitted for a second evaluation by an independent pharmacovigilance experts. STRENGTH AND LIMITATIONS OF THIS STUDY For our best knowledge, EREMI is the first large multicenter prospective and objective study in France with an active ADRs monitoring and independent ADRs validation. This study identifies the risk factors that could be used to adjust preventive actions in children's care, guides future research in the field and increases the awareness of physicians in off-label drug use and in detecting and declaring ADRs. As data are obtained through extraction of information from hospital database and medical records, there is likely to be some under-reporting of items or missing data. In this study the field specialists detect all adverse events, experts in pharmacovigilance centers assess them and finally only the ADRs assessed by the independent committee are confirmed. Although we recruit a high number of patients, this observational study is subject to different confounders.
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Affiliation(s)
- Kim An Nguyen
- Neonatal Intensive Care Unit and Neonatology, hôpital Femme-Mère-Enfant, Hospices civils de Lyon, 69500 Bron, France; Department of Pharmacotoxicology, Hospices civils de Lyon, 69003 Lyon, France; UMR 5558, CRNS, LBBE, EMET, Université Lyon, 69008 Lyon, France.
| | - Yanis Mimouni
- Inserm CIC 1407, EPICIME-Clinical Investigation Center, 69003 Lyon, France
| | - Elham Jaberi
- Inserm CIC 1407, EPICIME-Clinical Investigation Center, 69003 Lyon, France
| | - Nathalie Paret
- Department of Pharmacotoxicology, Hospices civils de Lyon, 69003 Lyon, France
| | - Inesse Boussaha
- Inserm CIC 1407, EPICIME-Clinical Investigation Center, 69003 Lyon, France
| | - Thierry Vial
- Department of Pharmacotoxicology, Hospices civils de Lyon, 69003 Lyon, France
| | | | - Corinne Alberti
- CIC EC 1426, Robert-Debré hospital/university of Paris, AP-HP, 75019, Paris, France
| | - Laure Guittard
- Pôle Santé publique, Service Recherche et Epidémiologie cliniques, Hospices civils de Lyon, 69003 Lyon, France; HESPER EA 7425, Université Claude Bernard Lyon 1, université Lyon, 69003 Lyon, France
| | - Laurent Remontet
- Department of Biostatistic, Hospices civils de Lyon, 69003 Lyon, France
| | - Laurent Roche
- Department of Biostatistic, Hospices civils de Lyon, 69003 Lyon, France
| | - Nadine Bossard
- Department of Biostatistic, Hospices civils de Lyon, 69003 Lyon, France
| | - Behrouz Kassai
- Department of Pharmacotoxicology, Hospices civils de Lyon, 69003 Lyon, France; UMR 5558, CRNS, LBBE, EMET, Université Lyon, 69008 Lyon, France; Inserm CIC 1407, EPICIME-Clinical Investigation Center, 69003 Lyon, France
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Sens F, Guittard L, Knebelmann B, Moranne O, Choukroun G, De-Précigout V, Couchoud C, Bravant E, Chakir MA, Lancelot L, Germain DP, Juillard L. P0047PREVALENCE OF FABRY DISEASE IN DIALYSIS PATIENTS IN FRANCE (FABRYDIAL STUDY). Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and Aims
Fabry Disease (FD) is an X linked lysosomal storage disease due to pathogenic α-galactosidase A (GLA) variants. It leads to damage in kidney and other organs. Numerous prevalence studies have been conducted over the past twenty years in ESRD patients in different countries. However, many screening studies did not perform confirmatory GLA variant analyses, and included recently recognized ‘benign/likely-benign’ variants, thereby inflating prevalence estimates. Thus, the prevalence of Fabry disease in patients with end-stage renal disease remains controversial.
The FABRYDIAL study aimed to measure the prevalence of Fabry disease in patients aged 18 to 75 years and treated by chronic dialysis, either hemodialysis or peritoneal dialysis.
Method
The study was conducted in France in 5 geographic sectors (Aquitaine, Ile-de-France, Rhône-Alpes and Picardie regions, and the Gard department). One hundred and twenty-four dialysis centers participated in the study, which targeted patients undergoing chronic dialysis during the week of November 20, 2017. The exclusion criteria were the existence of a proven nephropathy unrelated to FD (polycystic kidney disease, type 1 diabetes or biopsy-proven IgA nephropathy, membranous glomerulonephritis or ANCA-associated vasculitis), the absence of health insurance coverage or guardianship or tutelage. α-galactosidase A in men, and both α-galactosidase A and lyso-GL3 in women, were measured on a drop of dried blood during the usual care of patients. GLA gene sequencing was performed in patients in whom one biological value was outside normal values. If a genetic variant was identified, a multidisciplinary Diagnosis Validation Committee (DVC) concluded, based on precise literature, clinical, biological and genetic data, as to the reality of Fabry disease.
Results
Among the 6,032 patients aged 18 to 75 years under chronic dialysis during the period considered, 714 were no longer treated in the participating centers when the research staff visited for eligibility assessment. 1,121 had non-inclusion criteria, which in 89% of cases were a confirmed diagnosis of kidney disease (by renal biopsy or other means) making the existence of Fabry disease very unlikely. 4,197 patients met the inclusion criteria, of which 3,088 were included (1,888 men and 1,200 women). Valid biological analyzes were available for 2815 patients (1721 men and 1094 women), and a genetic test was indicated for 91 patients (52 men and 39 women). Ninety-seven percent of the samples were analyzed with a unique assay technique in a unique laboratory. Five patients had a genetic variant (4 men and one woman). After discussion in the DVC, one male patient was considered to have a confirmed Fabry disease. He presented early signs of the disease (first-degree family history of cardiac or unexplained death, hypohidrosis, heat intolerance, tendency to chronic diarrhea, angiokeratoma, hypoacousia and tinnitus) which could have been identified earlier. The GLA variant was c.1185dupG / p.Phe396Glyfs, a clearly pathogenic frameshift variant. The prevalence of FD in included patients with biological data was 0.035% [0.006; 0.201] (0.058% [0.010; 0.33] in men, 0.000 % [0,000; 0.350] in women). If we consider that patients who were not included because of a specific renal diagnosis unrelated to FD did not have FD, the estimated prevalence decreased to 0.028% [0.006; 0.121].
Conclusion
The estimated prevalence of FD in a cohort of French dialysis patients is 0.035% [0.006; 0.201], and by sex 0.058% in men [0.010; 0.328] and 0,000% in women [0,000; 0.35]. Although it appears extremely low, it remains justified to bring up this diagnosis in the event of an evocative sign, whether for the patient or his relatives as FD benefit of effective specific treatments.
Funding for this Investigator Sponsored Study was provided by Sanofi Genzyme
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Affiliation(s)
- Florence Sens
- Hospices Civils de Lyon, Edouard Herriot, Service de néphrologie et d’explorations fonctionnelles, Lyon, France
- Univ Lyon, Université Claude Bernard Lyon 1, CARMEN UMR INSERM 1060, Lyon, France
| | - Laure Guittard
- Hospices Civils de Lyon, Pôle Santé Publique, Service Recherche et Epidémiologie cliniques, Lyon, France
- Univ Lyon, Université Claude Bernard Lyon 1, HESPER EA 7425, Lyon, France
| | - Bertrand Knebelmann
- Assistance Publique Hôpitaux de Paris, Hôpital Necker, Service de néphrologie, Paris, France
| | - Olivier Moranne
- Nimes University Hospital, Service de Néphrologie, Nimes, France
- Université Montpellier-Nimes, Montpellier, France
| | | | - Valérie De-Précigout
- CHU Bordeaux, Hôpital Pellegrin Tripode, Service de néphrologie, Bordeaux, France
| | - Cécile Couchoud
- Agence de la biomédecine, Coordination Nationale Réseau Epidémiologique et Information en Néphrologie, Saint-Denis-La-Plaine, France
| | - Estelle Bravant
- Hospices Civils de Lyon, Pôle Santé Publique, Service Recherche et Epidémiologie cliniques, Lyon, France
- Univ Lyon, Université Claude Bernard Lyon 1, HESPER EA 7425, Lyon, France
| | - Mohammed A Chakir
- Hospices Civils de Lyon, Pôle Santé Publique, Service Recherche et Epidémiologie cliniques, Lyon, France
| | - Léa Lancelot
- Hospices Civils de Lyon, Pôle Santé Publique, Service Recherche et Epidémiologie cliniques, Lyon, France
| | - Dominique P Germain
- APHP Université Paris Saclay, Hôpital Raymond-Poincaré, Service de génétique médicale, Garches, France
| | - Laurent Juillard
- Hospices Civils de Lyon, Edouard Herriot, Service de néphrologie et d’explorations fonctionnelles, Lyon, France
- Univ Lyon, Université Claude Bernard Lyon 1, CARMEN UMR INSERM 1060, Lyon, France
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Fassier JB, Lamort-Bouché M, Broc G, Guittard L, Péron J, Rouat S, Carretier J, Fervers B, Letrilliart L, Sarnin P. Developing a Return to Work Intervention for Breast Cancer Survivors with the Intervention Mapping Protocol: Challenges and Opportunities of the Needs Assessment. Front Public Health 2018; 6:35. [PMID: 29527521 PMCID: PMC5829033 DOI: 10.3389/fpubh.2018.00035] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 01/31/2018] [Indexed: 01/02/2023] Open
Abstract
Return to work (RTW) is an important step for breast cancer survivors (BCSs). However, they face many barriers that affect particularly women with low socioeconomic status (SES). Health care, workplace, and insurance actors lack knowledge and collaborate poorly. No intervention to date has proven effective to reduce social disparities in employment after breast cancer. The intervention mapping (IM) protocol is being used in France to develop, implement, and evaluate an intervention to facilitate and sustain RTW after breast cancer [FAciliter et Soutenir le retour au TRAvail après un Cancer du Sein (FASTRACS) project]. The research question of this study was to elicit the needs for RTW after breast cancer from various stakeholders' point of view. The aim of this study was to describe the process and the preliminary results of the needs assessment of the FASTRACS project. Different methods were followed to (a) establish and work with a planning group and (b) conduct a needs assessment to create a logic model of the problem. A planning group was organized to gather the stakeholders with the research team. A review of the literature and indicators was conducted to identify the magnitude of the problem and the factors influencing RTW. A qualitative inquiry was conducted with 12 focus groups and 48 individual semi-structured interviews to explore the needs and experience of the stakeholders. The results of these tasks were the proposition of a charter of partnership to structure the participative process, a review of the scientific evidence and indicators, and the description by the stakeholders of their needs and experience. Many stakeholders disagreed with the concept of "early intervention." They advocated for a better support of BCSs during their RTW, emphasized as a process. Anticipation, intersectoral collaboration, and workplace accommodation were mentioned to fit the needs of the BCS and their environment. A logic model of the problem was elaborated from these data. The ability of the model to consider specific characteristics of women with low SES is discussed, with a view to developing the FASTRACS intervention through the next steps of the IM protocol.
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Affiliation(s)
- Jean-Baptiste Fassier
- UMRESTTE UMR T_9405, Unité mixte de recherche Epidémiologique et de Surveillance Transport Travail Environnement, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
- Service de médecine et santé au travail, Hospices civils de Lyon, Lyon, France
| | - Marion Lamort-Bouché
- UMRESTTE UMR T_9405, Unité mixte de recherche Epidémiologique et de Surveillance Transport Travail Environnement, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
- Collège universitaire de médecine générale, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - Guillaume Broc
- UMRESTTE UMR T_9405, Unité mixte de recherche Epidémiologique et de Surveillance Transport Travail Environnement, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - Laure Guittard
- HESPER, Health Services and Performance Research, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
- Pôle IMER, Hospices civils de Lyon, Lyon, France
| | - Julien Péron
- Laboratoire de Biométrie et Biologie Evolutive LBBE – UMR 5558, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France
- Service d’oncologie médicale. Institut de Cancérologie des Hospices Civils de Lyon (IC-HCL), Hospices civils de Lyon, Pierre-Bénite, France
| | - Sabrina Rouat
- GRePS – EA 4163 (Groupe de Recherche en Psychologie Sociale), Université Lumière Lyon 2, Université de Lyon, Lyon, France
| | - Julien Carretier
- Centre Léon Bérard, Département Cancer et Environnement, Lyon, France
| | - Béatrice Fervers
- Centre Léon Bérard, Département Cancer et Environnement, Lyon, France
- Faculté Lyon Est, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - Laurent Letrilliart
- Collège universitaire de médecine générale, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
- HESPER, Health Services and Performance Research, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - Philippe Sarnin
- GRePS – EA 4163 (Groupe de Recherche en Psychologie Sociale), Université Lumière Lyon 2, Université de Lyon, Lyon, France
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Nguyen K, Mimouni Y, Lajoinie A, Guittard L, Castellan C, Kassai B. SFP P-160 - Evènements indésirables médicamenteux et prescriptions hors AMM chez l’enfant. Arch Pediatr 2014. [DOI: 10.1016/s0929-693x(14)72130-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Cottin V, Reynaud-Gaubert M, Lacronique J, Nunes H, Thivolet-Béjui F, Danel C, Guelminger R, Guittard L, Termoz A, Durand C, Annesi-Maesano I, Schott A, Cordier J. Registre de la lymphangioléiomyomatose en France (RE•LAM•CE) et critères diagnostiques de la maladie. Rev Mal Respir 2014. [DOI: 10.1016/j.rmr.2013.10.294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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