Détermination et amélioration des critères décisionnels de prise en charge des personnes âgées atteintes de cancer

Abstract : Objective : To identify changes in the decision-making criteria of general ractitioners and oncologists concerning the care of elderly cancer patients after one year of corrective measures for care practices in the Lorraine region, France. Methods : In 2014, a postal mail questionnaire was sent to all GPs and oncologists in the Lorraine region. This questionnaire was designed to identify physicians decision-making criteria. It was based on the results of a literature review and on existing guidelines. During one year, corrective measures were implemented to improve practices, especially training sessions for physicians and production of specific tools including a guide to the accepted ideas in geriatric oncology. In 2015, the same questionnaire was resent to the same medical population to compare the answers. We also performed a complementary qualitative study of general practitioners and elderly people in charge of oncogeriatric consultation. Results : In 2014, 535 questionnaires were returned out of 2925 sent and in 2015, 480 were returned out of 2987 sent. Our results show for the first time that there exists a significant difference in the overall decision criteria between the two survey periods. Physicians tend to consider the principal decision criteria to be less important after the training period. GPs and oncologists express the importance of the interval before care begins. The qualitative study confirms this data, with a need for training. Patients express significant satisfaction with their care pathway. Conclusion : Training and information sessions for physicians remain the most important tool for improving care practices. The analysis of our data makes it possible to further integrate the patient into the care path, which remains a public health issue in terms of cost and organization
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http://docnum.univ-lorraine.fr/ulprive/DDOC_T_2017_0237_NIEMIER.pdf
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https://hal.univ-lorraine.fr/tel-01907817
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Submitted on : Monday, October 29, 2018 - 3:17:35 PM
Last modification on : Tuesday, October 30, 2018 - 1:16:41 AM

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Jean-Yves Niemier. Détermination et amélioration des critères décisionnels de prise en charge des personnes âgées atteintes de cancer. Médecine humaine et pathologie. Université de Lorraine, 2017. Français. ⟨NNT : 2017LORR0237⟩. ⟨tel-01907817⟩

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