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Valtuille Z, Acquaviva E, Trebossen V, Ouldali N, Bourmaud A, Sclison S, Gomez A, Revet A, Peyre H, Delorme R, Kaguelidou F. Psychotropic Medication Prescribing for Children and Adolescents After the Onset of the COVID-19 Pandemic. JAMA Netw Open 2024; 7:e247965. [PMID: 38652474 DOI: 10.1001/jamanetworkopen.2024.7965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Abstract
Importance Numerous studies have provided evidence for the negative associations of the COVID-19 pandemic with mental health, but data on the use of psychotropic medication in children and adolescents after the onset of the COVID-19 pandemic are lacking. Objective To assess the rates and trends of psychotropic medication prescribing before and over the 2 years after the onset of the COVID-19 pandemic in children and adolescents in France. Design, Setting, and Participants This cross-sectional study used nationwide interrupted time-series analysis of outpatient drug dispensing data from the IQVIA X-ponent database. All 8 839 143 psychotropic medication prescriptions dispensed to children (6 to 11 years of age) and adolescents (12 to 17 years of age) between January 2016 and May 2022 in France were retrieved and analyzed. Exposure Onset of COVID-19 pandemic. Main outcomes and Measures Monthly rates of psychotropic medication prescriptions per 1000 children and adolescents were analyzed using a quasi-Poisson regression before and after the pandemic onset (March 2020), and percentage changes in rates and trends were assessed. After the pandemic onset, rate ratios (RRs) were calculated between estimated and expected monthly prescription rates. Analyses were stratified by psychotropic medication class (antipsychotic, anxiolytic, hypnotic and sedative, antidepressant, and psychostimulant) and age group (children, adolescents). Results In total, 8 839 143 psychotropic medication prescriptions were analyzed, 5 884 819 [66.6%] for adolescents and 2 954 324 [33.4%] for children. In January 2016, the estimated rate of monthly psychotropic medication prescriptions was 9.9 per 1000 children and adolescents, with the prepandemic rate increasing by 0.4% per month (95% CI, 0.3%-0.4%). In March 2020, the monthly prescription rate dropped by 11.5% (95% CI, -17.7% to -4.9%). During the 2 years following the pandemic onset, the trend changed significantly, and the prescription rate increased by 1.3% per month (95% CI, 1.2%-1.5%), reaching 16.1 per 1000 children and adolescents in May 2022. Monthly rates of psychotropic medication prescriptions exceeded the expected rates by 11% (RR, 1.11 [95% CI, 1.08-1.14]). Increases in prescribing trends were observed for all psychotropic medication classes after the pandemic onset but were substantial for anxiolytics, hypnotics and sedatives, and antidepressants. Prescription rates rose above those expected for all psychotropic medication classes except psychostimulants (RR, 1.12 [95% CI, 1.09-1.15] in adolescents and 1.06 [95% CI, 1.05-1.07] in children for antipsychotics; RR, 1.30 [95% CI, 1.25-1.35] in adolescents and 1.11 [95% CI, 1.09-1.12] in children for anxiolytics; RR, 2.50 [95% CI, 2.23-2.77] in adolescents and 1.40 [95% CI, 1.30-1.50] in children for hypnotics and sedatives; RR, 1.38 [95% CI, 1.29-1.47] in adolescents and 1.23 [95% CI, 1.20-1.25] in children for antidepressants; and RR, 0.97 [95% CI, 0.95-0.98] in adolescents and 1.02 [95% CI, 1.00-1.04] in children for psychostimulants). Changes were more pronounced among adolescents than children. Conclusions and Relevance These findings suggest that prescribing of psychotropic medications for children and adolescents in France significantly and persistently increased after the COVID-19 pandemic onset. Future research should identify underlying determinants to improve psychological trajectories in young people.
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Affiliation(s)
- Zaba Valtuille
- Center of Clinical Investigations, Inserm CIC1426, Robert Debré University Hospital, APHP.Nord, Paris, France
- Paris Cité University, EA7323 Perinatal and Pediatric Pharmacology and Therapeutic Assessment, Paris, France
| | - Eric Acquaviva
- Department of Child and Adolescent Psychiatry, Robert Debré University Hospital, APHP.Nord, Paris Cité University, Paris, France
| | - Vincent Trebossen
- Department of Child and Adolescent Psychiatry, Robert Debré University Hospital, APHP.Nord, Paris Cité University, Paris, France
| | - Naim Ouldali
- Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, APHP.Nord, Paris Cité University, Paris, France
| | - Aurelie Bourmaud
- Clinical Epidemiology Unit, Inserm CIC1426, Robert Debré University Hospital, APHP.Nord, Paris Cité University, Paris, France
| | - Stéphane Sclison
- Consulting Services & Analytics Department, IQVIA, Courbevoie, France
| | - Alexandre Gomez
- Consulting Services & Analytics Department, IQVIA, Courbevoie, France
| | - Alexis Revet
- Department of Child and Adolescent Psychiatry, Toulouse University Hospital, Toulouse, France
- CERPOP, UMR 1295, Inserm, Toulouse III - Paul Sabatier University, Toulouse, France
| | - Hugo Peyre
- Autism Reference Centre of Languedoc-Roussillon CRA-LR, Montpellier University Hospital, Montpellier, France
- Excellence Centre for Autism and Neurodevelopmental disorders- CeAND, MUSE University, Montpellier, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France
| | - Richard Delorme
- Department of Child and Adolescent Psychiatry, Robert Debré University Hospital, APHP.Nord, Paris Cité University, Paris, France
- Human Genetics & Cognitive Functions, Institut Pasteur, Paris, France
| | - Florentia Kaguelidou
- Center of Clinical Investigations, Inserm CIC1426, Robert Debré University Hospital, APHP.Nord, Paris, France
- Paris Cité University, EA7323 Perinatal and Pediatric Pharmacology and Therapeutic Assessment, Paris, France
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Bey R, Cohen A, Trebossen V, Dura B, Geoffroy PA, Jean C, Landman B, Petit-Jean T, Chatellier G, Sallah K, Tannier X, Bourmaud A, Delorme R. Natural language processing of multi-hospital electronic health records for public health surveillance of suicidality. Npj Ment Health Res 2024; 3:6. [PMID: 38609541 PMCID: PMC10955903 DOI: 10.1038/s44184-023-00046-7] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 12/06/2023] [Indexed: 04/14/2024]
Abstract
There is an urgent need to monitor the mental health of large populations, especially during crises such as the COVID-19 pandemic, to timely identify the most at-risk subgroups and to design targeted prevention campaigns. We therefore developed and validated surveillance indicators related to suicidality: the monthly number of hospitalisations caused by suicide attempts and the prevalence among them of five known risks factors. They were automatically computed analysing the electronic health records of fifteen university hospitals of the Paris area, France, using natural language processing algorithms based on artificial intelligence. We evaluated the relevance of these indicators conducting a retrospective cohort study. Considering 2,911,920 records contained in a common data warehouse, we tested for changes after the pandemic outbreak in the slope of the monthly number of suicide attempts by conducting an interrupted time-series analysis. We segmented the assessment time in two sub-periods: before (August 1, 2017, to February 29, 2020) and during (March 1, 2020, to June 31, 2022) the COVID-19 pandemic. We detected 14,023 hospitalisations caused by suicide attempts. Their monthly number accelerated after the COVID-19 outbreak with an estimated trend variation reaching 3.7 (95%CI 2.1-5.3), mainly driven by an increase among girls aged 8-17 (trend variation 1.8, 95%CI 1.2-2.5). After the pandemic outbreak, acts of domestic, physical and sexual violence were more often reported (prevalence ratios: 1.3, 95%CI 1.16-1.48; 1.3, 95%CI 1.10-1.64 and 1.7, 95%CI 1.48-1.98), fewer patients died (p = 0.007) and stays were shorter (p < 0.001). Our study demonstrates that textual clinical data collected in multiple hospitals can be jointly analysed to compute timely indicators describing mental health conditions of populations. Our findings also highlight the need to better take into account the violence imposed on women, especially at early ages and in the aftermath of the COVID-19 pandemic.
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Affiliation(s)
- Romain Bey
- Innovation and Data unit, IT Department, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Ariel Cohen
- Innovation and Data unit, IT Department, Assistance Publique-Hôpitaux de Paris, Paris, France.
| | - Vincent Trebossen
- Child and Adolescent Psychiatry Department, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Basile Dura
- Innovation and Data unit, IT Department, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Pierre-Alexis Geoffroy
- Département de psychiatrie et d'addictologie, GHU Paris Nord, DMU neurosciences, Bichat - Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris, 75018, Paris, France
- GHU Paris - psychiatry & neurosciences, 1, rue Cabanis, 75014, Paris, France
- NeuroDiderot, Inserm, FHU I2-D2, université Paris Cité, 75019, Paris, France
- CNRS UPR 3212, Institute for cellular and integrative neurosciences, 67000, Strasbourg, France
| | - Charline Jean
- Innovation and Data unit, IT Department, Assistance Publique-Hôpitaux de Paris, Paris, France
- Université Paris-Est Créteil, INSERM, IMRB U955, Créteil, France
- Service Santé Publique & URC, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | - Benjamin Landman
- Child and Adolescent Psychiatry Department, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Thomas Petit-Jean
- Innovation and Data unit, IT Department, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Gilles Chatellier
- Innovation and Data unit, IT Department, Assistance Publique-Hôpitaux de Paris, Paris, France
- Université Paris Cité, Paris, France
| | - Kankoe Sallah
- URC PNVS, CIC-EC 1425, INSERM, Bichat - Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Xavier Tannier
- Sorbonne Université, Inserm, Université Sorbonne Paris Nord, Laboratoire d'Informatique Médicale et d'Ingénierie des Connaissances pour la e-Santé (LIMICS), Paris, France
| | - Aurelie Bourmaud
- Université Paris Cité, Paris, France
- Clinical Epidemiology Unit, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- CIC 1426, Inserm, Paris, France
| | - Richard Delorme
- Child and Adolescent Psychiatry Department, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Human Genetics and Cognitive Functions, Institut Pasteur, Paris, France
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Baudot A, Barth N, Colas C, Garros M, Garcin A, Oriol M, Collange F, Bongue B, Roche F, Chauvin F, Bourmaud A, Hupin D. The Acti-Pair program helps men with prostate cancer increase physical activity with peer support: a mixed method pilot study. Front Public Health 2024; 11:1321230. [PMID: 38259748 PMCID: PMC10800526 DOI: 10.3389/fpubh.2023.1321230] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/11/2023] [Indexed: 01/24/2024] Open
Abstract
Background Although the health benefits of physical activity (PA) are recognized, prostate cancer patients do not follow PA recommendations. Barriers to PA, whether physical, environmental or organizational, are known. Furthermore, even when these barriers are overcome, this achievement is not systematically accompanied by lifestyle change. Many strategies have shown to be effective in increasing patient adherence to PA. This study aims to assess the feasibility and the viability of the Acti-Pair program which combines three strategies: peer support, a personalized and realistic PA project, and support from health and adapted physical activity professionals in a local context. Methods and analysis We conducted a pilot study utilizing a mixed qualitative and quantitative methodology, employing feasibility and viability assessments. Quantitative assessments included recruitment, retention adherence rates, process and potential effectiveness (PA and motivation) indicators; while qualitative methods were used to evaluate the program's practicality, suitability and usefulness. Indicators of potential effectiveness were assessed before and after the intervention using a Wilcoxon test for matched data. Qualitative data were collected through semistructured interviews conducted by two researchers with various program stakeholders. The study lasted for 3 years. Results Twenty-four patients were recruited over a 25-month period. Forty-two percent of patients completed the program 3 months after the beginning. We recruited 14 peers and trained nine peers over a 10-month period. The program was coordinated extensively by adapted PA professionals, while health professionals were involved in recruiting patients and peers. Self-reporting of moderate to vigorous PA was increased after the Acti-Pair program initiation [42.86 (30.76) at baseline to 53.29 (50.73)]. Intrinsic motivation significantly increased after participation in the Acti-Pair program [1.76 (1.32) before the intervention vs. 2.91 (1.13) after the intervention]. The key player to support the Acti-Pair program in the field has been the PA support system. The main challenge has been the difficulty of health professionals in promoting PA. Discussion This pilot study has shown that the Acti-Pair program is feasible and viable. It will allow us to extend the peer support intervention to other contexts and assess the effectiveness of this intervention and its generalization.
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Affiliation(s)
- Amandine Baudot
- National Institute of Health and Medical (INSERM) CIC1408 Centre d'Investigation Clinique Saint-Etienne, Saint-Etienne, France
- Unité de recherche Clinique, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
- National Institute of Health and Medical Research (INSERM) U1059 SAnté INgéniérie BIOlogie, Saint-Etienne, France
- Presage Institute - Université Jean Monnet, Saint-Etienne, France
| | - Nathalie Barth
- National Institute of Health and Medical Research (INSERM) U1059 SAnté INgéniérie BIOlogie, Saint-Etienne, France
- Presage Institute - Université Jean Monnet, Saint-Etienne, France
- Chaire santé des aînés - Université Jean Monnet, Saint-Etienne, France
- Gérontopôle Auvergne Rhône-alpes, Saint-Etienne, France
| | - Claire Colas
- National Institute of Health and Medical Research (INSERM) U1059 SAnté INgéniérie BIOlogie, Saint-Etienne, France
- Department of Clinical and Exercise Physiology, University Hospital Center of Saint-Etienne, Saint-Etienne, France
| | - Maël Garros
- Sport-Health House, Departmental Olympic and Sports Committee of the Loire (42), Saint-Etienne, France
| | - Arnauld Garcin
- Unité de recherche Clinique, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
| | - Mathieu Oriol
- Centre Technique d'Appui et de Formation (CETAF), Saint-Etienne, France
| | - Fanny Collange
- National Institute of Health and Medical (INSERM) CIC1408 Centre d'Investigation Clinique Saint-Etienne, Saint-Etienne, France
- Presage Institute - Université Jean Monnet, Saint-Etienne, France
| | - Bienvenu Bongue
- National Institute of Health and Medical Research (INSERM) U1059 SAnté INgéniérie BIOlogie, Saint-Etienne, France
- Presage Institute - Université Jean Monnet, Saint-Etienne, France
- Chaire santé des aînés - Université Jean Monnet, Saint-Etienne, France
| | - Frederic Roche
- National Institute of Health and Medical Research (INSERM) U1059 SAnté INgéniérie BIOlogie, Saint-Etienne, France
- Presage Institute - Université Jean Monnet, Saint-Etienne, France
- Chaire santé des aînés - Université Jean Monnet, Saint-Etienne, France
- Department of Clinical and Exercise Physiology, University Hospital Center of Saint-Etienne, Saint-Etienne, France
| | - Franck Chauvin
- National Institute of Health and Medical (INSERM) CIC1408 Centre d'Investigation Clinique Saint-Etienne, Saint-Etienne, France
- Presage Institute - Université Jean Monnet, Saint-Etienne, France
| | - Aurelie Bourmaud
- National Institute of Health and Medical Research (INSERM) U1137 Infection, Antimicrobiens, Modélisation, Evolution, Paris, France
- National Institute of Health and Medical Research (INSERM) CIC1426 Centre d'Investigation Clinique Robert Debré, Paris, France
| | - David Hupin
- National Institute of Health and Medical Research (INSERM) U1059 SAnté INgéniérie BIOlogie, Saint-Etienne, France
- Presage Institute - Université Jean Monnet, Saint-Etienne, France
- Chaire santé des aînés - Université Jean Monnet, Saint-Etienne, France
- Department of Clinical and Exercise Physiology, University Hospital Center of Saint-Etienne, Saint-Etienne, France
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Bourmaud A, Fianu A, Kervran C, Verga-Gérard A, Fournel I, Dumas A, Mancini J, Alla F, Omorou A, Giraudeau B. Corrigendum de l'article « Version française des recommandations de la déclaration d'Ottawa sur la conception et la conduite éthique d'essais randomisés en clusters, dans le contexte législatif français » [RESPE 71 (2023) 101847]. Rev Epidemiol Sante Publique 2023; 71:102188. [PMID: 37939627 DOI: 10.1016/j.respe.2023.102188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023] Open
Affiliation(s)
- A Bourmaud
- Unité d'épidémiologie clinique, CIC-EC 1426, Hôpital Universitaire Robert Debré, AP-HP, Paris et Université Paris-Cité, Paris, France.
| | - A Fianu
- Inserm CIC1410, CHU Réunion, Saint-Pierre, France/CERPOP, Université de Toulouse, Inserm, UPS, Toulouse, France
| | - C Kervran
- Equipe MeRISP, Inserm UMR U1219, Bordeaux Population Health Research Center (BPH), Université de Bordeaux, Bordeaux, France
| | - A Verga-Gérard
- CIC-EC 1433, Nancy, Inserm ; RECaP/ F-CRIN, Nancy, France
| | - I Fournel
- CHU Dijon Bourgogne, Inserm, Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique, F21000 Dijon, France
| | - A Dumas
- Université Paris-Cité, ECEVE UMR 1123, Inserm, Paris, France
| | - J Mancini
- Aix Marseille Université, AP-HM, Inserm, IRD, ISSPAM, SESSTIM, BioSTIC, Marseille, France
| | - F Alla
- Université de Bordeaux, Inserm U1218, Bordeaux 33000, France ; Prevention Department, Centre hospitalier universitaire de Bordeaux, France
| | - A Omorou
- CHRU-Nancy, Inserm, Université de Lorraine, CIC, Epidémiologie clinique, F-54000 Nancy, France
| | - B Giraudeau
- Université de Tours, Université de Nantes, Inserm, SPHERE U1246, Tours, France ; INSERM CIC1415, CHRU de Tours, Tours, France
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Bourmaud A, Fianu A, Kervan C, Verga-Gérard A, Fournel I, Dumas A, Mancini J, Alla F, Omorou A, Giraudeau B. [French version of The Ottawa Statement on the Ethical Design and Conduct of Cluster Randomized Trials, in a French law context]. Rev Epidemiol Sante Publique 2023; 71:101847. [PMID: 37167813 DOI: 10.1016/j.respe.2023.101847] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 01/06/2023] [Accepted: 03/27/2023] [Indexed: 05/13/2023] Open
Abstract
INTRODUCTION There is growing evidence on the ethical challenges raised by cluster randomized trials. This specificity is not reflected in the legal texts regulating research, which creates difficulties for researchers implementing these experimental designs. The Ottawa Statement (Weijer et al. 2012) aims to provide detailed guidance on the ethical design, conduct and assessment of cluster trials. More broadly aims to help research stakeholders and decision-makers to make informed ethical decisions regarding the particularity of these experimental designs. It seems that this international statement, written in English, is not sufficiently accessible to all of the French professionals involved in health research. The aim of this article is to provide these professionals with a contextualized and illustrated French translation of the "Ottawa statement". METHOD . The "complex design" working group of the RECaP network (Research in Clinical Epidemiology and Public Health), carried out this work. A first version was discussed by the authors in several meetings. It was completed by contextual explanations and examples of French studies currently conducted by the authors. The final version was obtained by consensus and validated by the group. RESULTS . This work reports 15 recommendations grouped into 7 key questions: How to justify cluster design? How to submit an article to an ethics committee? How to identify research participants? How and when to obtain informed consent? Who are the gatekeepers? How to assess benefits and harm? How to protect vulnerable participants? Each of these recommendations is specific to cluster trials. The recommendations are explained and detailed through concrete examples. CONCLUSION Without interfering with current French laws, this work provides a framework for the organization, conduct and ethical assessment of cluster randomized trials in France. In the present-day context, it is essential that all concerned groups can base their decisions on recommendations in line with the elementary principles of health research ethics.
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Affiliation(s)
- A Bourmaud
- Unité d'épidémiologie clinique, CIC-EC 1426, Hôpital Universitaire Robert Debré, AP-HP, Paris et Université Paris-Cité, Paris, France.
| | - A Fianu
- Inserm CIC1410, CHU Réunion, Saint-Pierre, France/CERPOP, Université de Toulouse, Inserm, UPS, Toulouse, France
| | - C Kervan
- Equipe MeRISP, Inserm UMR U1219, Bordeaux Population Health Research Center (BPH), Université de Bordeaux, Bordeaux, France
| | - A Verga-Gérard
- CIC-EC 1433, Nancy, Inserm ; RECaP/ F-CRIN, Nancy, France
| | - I Fournel
- CHU Dijon Bourgogne, Inserm, Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique, F21000 Dijon, France
| | - A Dumas
- Université Paris-Cité, ECEVE UMR 1123, Inserm, Paris, France
| | - J Mancini
- Aix Marseille Université, AP-HM, Inserm, IRD, ISSPAM, SESSTIM, BioSTIC, Marseille, France
| | - F Alla
- Université de Bordeaux, Inserm U1218, Bordeaux 33000, France; Prevention Department, Centre hospitalier universitaire de Bordeaux, France
| | - A Omorou
- CHRU-Nancy, Inserm, Université de Lorraine, CIC, Epidémiologie clinique, F-54000 Nancy, France
| | - B Giraudeau
- Université de Tours, Université de Nantes, Inserm, SPHERE U1246, Tours, France; INSERM CIC1415, CHRU de Tours, Tours, France
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Courbebaisse M, Bourmaud A, Souberbielle JC, Sberro-Soussan R, Moal V, Le Meur Y, Kamar N, Albano L, Thierry A, Dantal J, Danthu C, Moreau K, Morelon E, Heng AE, Bertrand D, Arzouk N, Perrin P, Morin MP, Rieu P, Presne C, Grimbert P, Ducloux D, Büchler M, Le Quintrec M, Ouali N, Pernin V, Bouvier N, Durrbach A, Alamartine E, Randoux C, Besson V, Hazzan M, Pages J, Colas S, Piketty ML, Friedlander G, Prié D, Alberti C, Thervet E. Nonskeletal and skeletal effects of high doses versus low doses of vitamin D 3 in renal transplant recipients: Results of the VITALE (VITamin D supplementation in renAL transplant recipients) study, a randomized clinical trial. Am J Transplant 2023; 23:366-376. [PMID: 36695682 DOI: 10.1016/j.ajt.2022.12.007] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 12/02/2022] [Accepted: 12/02/2022] [Indexed: 01/11/2023]
Abstract
Vitamin D sufficiency is associated with a reduced risk of fractures, diabetes mellitus, cardiovascular events, and cancers, which are frequent complications after renal transplantation. The VITALE (VITamin D supplementation in renAL transplant recipients) study is a multicenter double-blind randomized trial, including nondiabetic adult renal transplant recipients with serum 25-hydroxy vitamin D (25(OH) vitamin D) levels of <30 ng/mL, which is randomized 12 to 48 months after transplantation to receive high (100 000 IU) or low doses (12 000 IU) of cholecalciferol every 2 weeks for 2 months and then monthly for 22 months. The primary outcome was a composite endpoint, including diabetes mellitus, major cardiovascular events, cancer, and death. Of 536 inclusions (50.8 [13.7] years, 335 men), 269 and 267 inclusions were in the high-dose and low-dose groups, respectively. The serum 25(OH) vitamin D levels increased by 23 versus 6 ng/mL in the high-dose and low-dose groups, respectively (P < .0001). In the intent-to-treat analysis, 15% versus 16% of the patients in the high-dose and low-dose groups, respectively, experienced a first event of the composite endpoint (hazard ratio, 0.94 [0.60-1.48]; P = .78), whereas 1% and 4% of patients in the high-dose and low-dose groups, respectively, experienced an incident symptomatic fracture (odds ratio, 0.24 [0.07-0.86], P = .03). The incidence of adverse events was similar between the groups. After renal transplantation, high doses of cholecalciferol are safe but do not reduce extraskeletal complications (trial registration: ClinicalTrials.gov; identifier: NCT01431430).
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Affiliation(s)
- Marie Courbebaisse
- Paris University; Physiology Department, European Georges-Pompidou Hospital, APHP; INSERM U1151. Paris, France.
| | - Aurelie Bourmaud
- APHP.Nord-Université de Paris, Hôpital Universitaire Robert Debré, Unité d'Epidémiologie Clinique, Inserm, CIC 1426, F-75019 Paris, France; Université de Paris, ECEVE UMR 1123, INSERM. F-75010 Paris, France
| | - Jean-Claude Souberbielle
- Service des explorations fonctionnelles hôpital Necker-Enfants Malades, DMU Biophygen, GHU Centre Université de Paris APHP. Paris, France
| | - Rebecca Sberro-Soussan
- Université de Paris; Service de Transplantation Rénale et Néphrologie, Hôpital Necker Enfant Malades, APHP. Paris, France
| | - Valérie Moal
- Aix-Marseille Université - AP-HM - Hôpital Conception - Centre de Néphrologie et Transplantation Rénale. Marseille, France
| | - Yannick Le Meur
- Department of Nephrology, CHU de Brest; UMR1227, Lymphocytes B et Autoimmunité, Université de Brest, Inserm, Labex IGO. Brest, France
| | - Nassim Kamar
- Department of Nephrology, Dialysis and Organ Transplantation, CHU Rangueil, INSERM U1043, IFR -BMT, University Paul Sabatier. Toulouse, France
| | - Laetitia Albano
- Service de Transplantation Rénale, CHU de Nice. Nice, France
| | - Antoine Thierry
- Service de Néphrologie, INSERM U1082 et Fédération Hospitalo-Universitaire BIOSUPORT. Poitiers, France
| | - Jacques Dantal
- CRTI (Centre de Recherche en Transplantation et Immunologie) INSERM UMR1064, Université de Nantes, Centre Hospitalier Universitaire de Nantes. Nantes, France
| | - Clément Danthu
- Department of Nephrology, Limoges University hospital; UMR INSERM 1092, RESINFIT, Limoges University hospital 2. Limoges, France
| | - Karine Moreau
- Unité de transplantation rénale, Hôpital Pellegrin, CHU de Bordeaux. Bordeaux, France
| | - Emmanuel Morelon
- Service de transplantation, néphrologie et immunologie clinique, Hôpital Edouard Herriot, Hospices Civils de Lyon; INSERM U1111, Université Claude Bernard Lyon1. Lyon, France
| | - Anne-Elisabeth Heng
- Service de Néphrologie, Dialyse, Transplantation, CHU de Clermont-Ferrand; Université Clermont Auvergne. F-63000 Clermont-Ferrand, France
| | - Dominique Bertrand
- Nephrology, dialysis and kidney transplantation, Rouen University Hospital. Rouen, France
| | - Nadia Arzouk
- Service de Transplantation Rénale, hôpital La Pitié-Salpétrière, APHP. Paris, France
| | - Peggy Perrin
- Department of Nephrology and Transplantation, Strasbourg University Hospital; Fédération de Médecine Translationnelle, INSERM U1109, LabEx TRANSPLANTEX. Strasbourg, France
| | | | - Philippe Rieu
- Division of Nephrology, Reims university hospital, CRNS UMR 7369 MEDyC laboratory. Reims, France
| | - Claire Presne
- Nephrology Internal Medicine Dialysis Transplantation Department, Amiens University Hospital. Amiens France
| | - Philippe Grimbert
- Nephrology and Transplant Department, CHU Henri-Mondor, APHP; Université Paris Est Créteil, INSERM U955. Paris, France
| | - Didier Ducloux
- Department of Nephrology, CHU Besançon. Besançon, France
| | - Matthias Büchler
- Department of Nephrology and Transplantation, CHU Tours; University of Tours, EA4245 Transplantation, Immunology, Inflammation; FHU SUPORT. Tours, France
| | | | - Nacéra Ouali
- Nephrology department, SINRA, Hôpital Tenon. Paris, France
| | - Vincent Pernin
- University of Montpellier, Department of Nephrology, Dialysis and Transplantation, Montpellier University hospital; Institute for Regenerative Medicine & Biotherapy (IRMB), INSERM U1183. Montpellier, France
| | - Nicolas Bouvier
- Service de Néphrologie-Dialyse-Transplantation, CHU Caen Normandie; Université de Caen Normandie. Caen, France
| | - Antoine Durrbach
- Université Paris Saclay, France; INSERM UMR 1186, Gustave Roussy. Villejuif, France; Nephrology Department, Bicêtre Hospital APHP. Le Kremlin-Bicêtre, France
| | - Eric Alamartine
- CHU de Saint Etienne et CIRI - INSERM U1111 - CNRS UMR5308 - ENS Lyon/UCBL1/Université St Etienne. Saint Etienne, France
| | - Christine Randoux
- Service de Néphrologie, CHU Bichat Claude Bernard, APHP.Nord. Paris, France
| | - Virginie Besson
- Service de Néphrologie-Dialyse-transplantation, CHU d'Angers. Angers, France
| | - Marc Hazzan
- Université de Lille, INSERM, CHU Lille, U1286 - Infinite - Institute for Translational Research in Inflammation. F-59000 Lille, France
| | - Justine Pages
- APHP.Nord-Université de Paris, Hôpital Universitaire Robert Debré, Unité d'Epidémiologie Clinique, INSERM, CIC 1426. F-75019 Paris, France
| | - Sandra Colas
- Unité de Recherche Clinique Necker-Cochin, APHP. Paris, France
| | - Marie-Liesse Piketty
- Service des explorations fonctionnelles hôpital Necker-Enfants Malades, DMU Biophygen, GHU Centre Université de Paris APHP. Paris, France
| | | | - Dominique Prié
- Université de Paris; INSERM U1151, service des explorations fonctionnelles hôpital Necker-Enfants Malades, DMU Biophygen, GHU Centre Université de Paris APHP. Paris, France
| | - Corinne Alberti
- APHP.Nord-Université de Paris, Hôpital Universitaire Robert Debré, Unité d'Epidémiologie Clinique, Inserm, CIC 1426, F-75019 Paris, France; Université de Paris, ECEVE UMR 1123, INSERM. F-75010 Paris, France
| | - Eric Thervet
- Paris University; Nephrology Department, European Georges-Pompidou Hospital, APHP; INSERM UMR 970, Paris Cardiovascular Research Center. Paris, France
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Bourmaud A, Benoist Y, Tinquaut F, Allary C, Ramone-Louis J, Oriol M, Kalecinski J, Dutertre V, Lechopier N, Pommier M, Rousseau S, Dumas A, Amiel P, Regnier V, Buthion V, Chauvin F. Patient navigation for colorectal cancer screening in deprived areas: the COLONAV cluster randomized controlled trial. BMC Cancer 2023; 23:21. [PMID: 36609248 PMCID: PMC9817361 DOI: 10.1186/s12885-022-10169-3] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 09/29/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The objective of this study was to assess the effectiveness of a Patient Navigation Intervention targeting deprived patients for Colo-Rectal Cancer (CRC) screening participation. METHODS A cluster randomized controlled trial was conducted in 5 districts. Peer Lay Patient Navigators were recruited to operate in deprived areas. Eligible participants had to be between 50 and 74 years old, live in these deprived areas and receive an invitation to the nationally organized Colo-Rectal Cancer (CRC) screening during the study period. The theory-driven navigation intervention was deployed for 18 months. A population Health Intervention Research assessment method was used to assess effectiveness and context interaction. The primary criterion was screening participation at 12 months. RESULTS Twenty-four thousand two hundred eighty-one individuals were included inside 40 clusters. The increase in participation in the intervention group was estimated at 23%, (ORa = 1.23, CI95% [1.07-1.41], p = 0.003). For the subgroup of individuals who participated, the time delay to participating was reduced by 26% (ORa = 0.74, CI95% [0.57-0.96], p = 0.021). Main factors modulating the effect of the intervention were: closeness of navigator profiles to the targeted population, navigators' abilities to adapt their modus operandi, and facilitating attachment structure. CONCLUSION The ColoNav Intervention succeeded in demonstrating its effectiveness, for CRC screening. Patient Navigation should be disseminate with broader health promotion goals in order to achieve equity in health care. TRIAL REGISTRATION clinicaltrials.gov NCT02369757 24/02/2015.
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Affiliation(s)
- A. Bourmaud
- grid.10988.380000 0001 2173 743XClinical Epidemiology Unit, Robert Debré Hospital, AP-HP, and INSERM CIC-EC 1426 and INSERM ECEVE 1123, University of Paris, 48 Bd Sérurier, 75 019 Paris, France ,grid.457361.2Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France and Inserm, Clinical Investigation Center 1408, 42055 Saint-Etienne, France ,grid.7849.20000 0001 2150 7757Quality Safety Performance in Health (HESPER) EA7425, Lyon 1 University, Lyon, France
| | - Y. Benoist
- grid.14925.3b0000 0001 2284 9388Unité de Recherche en Sciences Humaines Et Sociales (URSHS) Institut Gustave Roussy, Paris, France
| | - F. Tinquaut
- grid.457361.2Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France and Inserm, Clinical Investigation Center 1408, 42055 Saint-Etienne, France
| | - C. Allary
- grid.457361.2Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France and Inserm, Clinical Investigation Center 1408, 42055 Saint-Etienne, France
| | - J. Ramone-Louis
- grid.72960.3a0000 0001 2188 0906COACTIS EA 4161 - Centre de Recherche en Gestion - Research Center in Management Science ISH and Faculty of Economics and Management, Lumière Lyon 2 University, Lyon, France
| | - M. Oriol
- grid.457361.2Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France and Inserm, Clinical Investigation Center 1408, 42055 Saint-Etienne, France
| | - J. Kalecinski
- grid.457361.2Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France and Inserm, Clinical Investigation Center 1408, 42055 Saint-Etienne, France ,grid.7849.20000 0001 2150 7757Quality Safety Performance in Health (HESPER) EA7425, Lyon 1 University, Lyon, France
| | - V. Dutertre
- grid.457361.2Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France and Inserm, Clinical Investigation Center 1408, 42055 Saint-Etienne, France
| | - N. Lechopier
- Lyon1 University, Lyon, France ,grid.15140.310000 0001 2175 9188UMR S2HEP, French Education Institute, Ecole Normale Supérieure de Lyon, Lyon, France
| | - M. Pommier
- grid.15140.310000 0001 2175 9188UMR S2HEP, French Education Institute, Ecole Normale Supérieure de Lyon, Lyon, France
| | - S. Rousseau
- grid.457361.2Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France and Inserm, Clinical Investigation Center 1408, 42055 Saint-Etienne, France ,grid.14925.3b0000 0001 2284 9388Unité de Recherche en Sciences Humaines Et Sociales (URSHS) Institut Gustave Roussy, Paris, France
| | - A. Dumas
- grid.10988.380000 0001 2173 743XClinical Epidemiology Unit, Robert Debré Hospital, AP-HP, and INSERM CIC-EC 1426 and INSERM ECEVE 1123, University of Paris, 48 Bd Sérurier, 75 019 Paris, France ,grid.14925.3b0000 0001 2284 9388Unité de Recherche en Sciences Humaines Et Sociales (URSHS) Institut Gustave Roussy, Paris, France
| | - P. Amiel
- grid.10988.380000 0001 2173 743XClinical Epidemiology Unit, Robert Debré Hospital, AP-HP, and INSERM CIC-EC 1426 and INSERM ECEVE 1123, University of Paris, 48 Bd Sérurier, 75 019 Paris, France ,grid.14925.3b0000 0001 2284 9388Unité de Recherche en Sciences Humaines Et Sociales (URSHS) Institut Gustave Roussy, Paris, France
| | - V. Regnier
- grid.457361.2Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France and Inserm, Clinical Investigation Center 1408, 42055 Saint-Etienne, France ,grid.7849.20000 0001 2150 7757Quality Safety Performance in Health (HESPER) EA7425, Lyon 1 University, Lyon, France
| | - V. Buthion
- grid.72960.3a0000 0001 2188 0906COACTIS EA 4161 - Centre de Recherche en Gestion - Research Center in Management Science ISH and Faculty of Economics and Management, Lumière Lyon 2 University, Lyon, France
| | - F. Chauvin
- grid.457361.2Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France and Inserm, Clinical Investigation Center 1408, 42055 Saint-Etienne, France ,grid.7849.20000 0001 2150 7757Quality Safety Performance in Health (HESPER) EA7425, Lyon 1 University, Lyon, France
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Bourmaud A, Piot de Villars E, Renault-Teissier E. [Patient partnership and patient education in oncology]. Bull Cancer 2021; 109:588-597. [PMID: 34782118 DOI: 10.1016/j.bulcan.2021.09.016] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 09/16/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Over the last 40years, the French health system has opened up to patient engagement. Society has recognised the legitimacy of the patient as a decision-maker in his or her own health and as an expert in his or her illness. This is true at the individual level in the context of doctor-patient relationship, and at the organisational level within institutions, in decision-making or academic groups. The aim of this study is to present the concepts of patient-partnership, patient education and to illustrate the different functions that patient-partners can take within the organisation of patient education programmes, and in the field of oncology. METHOD A narrative review of the literature was carried out to extract relevant and recent seminal articles to address these points. RESULTS The Montreal model establishes the patient partner as a full care actor. He can thus contribute his expertise in many fields of application: care, research or teaching. The aim of patient education is to empower the patient in the management of his or her disease, treatment and the consequences of these on daily life. The patient partner has a full place in this system where he can accompany his peers, but also collaborate with the educational team to develop new programmes, evaluate them and even conduct research. The implementation of these systems consists of getting individuals with different cultures and operating methods to work together. It is a process that requires time, effort and attention to each other.
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Affiliation(s)
- Aurelie Bourmaud
- Universitary hospital Robert-Debré, université de Paris, Clinical epidemiology unit, Inserm ECEVE, 1123 Paris, France.
| | | | - Evelyne Renault-Teissier
- Pain unit, DISSPO, douleur et soins palliatifs, universitary comprehensive cancer institut, Institut Curie, Paris, France
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Terrier JE, Ruffion A, Hamant C, Rousset V, Kalecinski J, Baudot A, Dumas A, Chauvin F, Bourmaud A. Patient Education for Radical Prostatectomy: Development of a Program Tailored to the Needs of Prostate Cancer Patients. Am J Mens Health 2021; 15:15579883211063317. [PMID: 34923862 PMCID: PMC8721889 DOI: 10.1177/15579883211063317] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/08/2021] [Accepted: 11/11/2021] [Indexed: 12/24/2022] Open
Abstract
In all, 30% to 90% of prostate cancer patients undergoing radical prostatectomy (RP) recover their erectile capacity. No effective post RP erectile rehabilitation program exists to date. The aim of this exploratory qualitative study is to explore the needs of these patients and to develop a patient education program (PEP) which meets these needs. Interviews were carried out by a socio-anthropologist with prostate cancer patients treated by RP within the 6 previous months. The needs and expectations identified led to the choice of a logical model of change for the construction of the PEP. Nineteen patients were included in the study; 17 of them were living with a partner. Two categories of patients appeared during the interviews: informed patients resigned to lose their sexuality and patients misinformed about the consequences of the surgery. The tailored program was built on the Health Belief Model and provides six individual sessions, including one with the partner, to meet the needs identified. This study designed the first program to target comprehensively the overall sexuality of the patient and his partner, and not only erection issues. To demonstrate the effectiveness of this program, a controlled, multicentric clinical trial is currently ongoing.
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Affiliation(s)
- Jean-Etienne Terrier
- Department of Urology, Centre Hospitalier Lyon Sud, Lyon, France
- Health Services and Performance Research Unit, EA 74 25, Lyon 1 University, Lyon, France
| | - Alain Ruffion
- Department of Urology, Centre Hospitalier Lyon Sud, Lyon, France
| | - Chloé Hamant
- Hygée Center, University Hospital of Saint Etienne, Saint Etienne, France
| | - Vanessa Rousset
- Hygée Center, University Hospital of Saint Etienne, Saint Etienne, France
| | - Julie Kalecinski
- Hygée Center, University Hospital of Saint Etienne, Saint Etienne, France
| | - Amandine Baudot
- Hygée Center, University Hospital of Saint Etienne, Saint Etienne, France
| | | | - Franck Chauvin
- Health Services and Performance Research Unit, EA 74 25, Lyon 1 University, Lyon, France
- Hygée Center, University Hospital of Saint Etienne, Saint Etienne, France
| | - Aurelie Bourmaud
- INSERM U1123 ECEVE, Paris, France
- Robert Debré University Hospital, Paris, France
- Université de Paris, Paris, France
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Bourmaud A, Chauvin F. Which communication strategies can improve interventions aimed at tackling social inequalities in organized cancer screening in France? Glob Health Promot 2021; 28:89-92. [PMID: 33843345 PMCID: PMC7897540 DOI: 10.1177/1757975921989505] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 11/20/2020] [Indexed: 11/15/2022]
Abstract
Interventions to increase participation in cancer screening programs have been developed and evaluated by our research team. The results observed provide an opportunity to consider which methods of communication should be encouraged to improve those interventions. The objective of this commentary is to recommend communication strategies which should be adopted to efficiently reach and support disadvantaged individuals to engage in cancer screening, as a healthy behaviour.
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Affiliation(s)
- Aurelie Bourmaud
- Clinical Epidemiology Unit, Universitary Hospital Robert Debré, Université de Paris, Institut national de la santé et de la recherche médicale (Inserm) ECEVE 1123, Paris, France
| | - Franck Chauvin
- Institut national de la santé et de la recherche médicale (Inserm) CIC 1408, High Council for Public Health, Jean Monnet University, Saint Etienne, France
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11
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Martin P, Alberti C, Gottot S, Bourmaud A, de La Rochebrochard E. Expert Opinions on Web-Based Peer Education Interventions for Youth Sexual Health Promotion: Qualitative Study. J Med Internet Res 2020; 22:e18650. [PMID: 33231552 PMCID: PMC7723739 DOI: 10.2196/18650] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 03/13/2020] [Revised: 06/26/2020] [Accepted: 07/26/2020] [Indexed: 11/13/2022] Open
Abstract
Background Participatory education, in the form of peer education, may be an effective way to promote youth sexual health. With the advent of the internet, web-based interventions have potential as an attractive new tool for sexual health promotion by peers. Objective The aim of this study was to evaluate professional experts’ opinions on the perspectives for web-based participatory interventions to promote sexual health by peers and among young people. Methods Semistructured interviews were carried out with 20 experts (stakeholders in direct contact with young people, researchers, and institutional actors) specializing in sexual health, health promotion, peer education, youth, internet, and social media. After coding with N’Vivo, data were subjected to qualitative thematic analysis. Results The majority of experts (18/20, 90%) found this kind of intervention to be attractive, but highlighted the necessary conditions, risks, and limitations attached to developing an acceptable peer intervention on the internet for sexual health promotion among young people. Five main themes were identified: (1) an internet intervention; (2) sexual health; (3) internet skills, and uses and the need for moderation; (4) multifaceted peers; and (5) minority peers. In the absence of youth interest for institutional messages, the experts highlighted the attractive participatory features of web-based interventions and the need for geolocalized resources. However, they also warned of the limitations associated with the possibility of integrating peers into education: peers should not be mere messengers, and should remain peers so as not to be outsiders to the target group. Experts highlighted concrete proposals to design an online participatory peer intervention, including the process of peer implication, online features in the intervention, and key points for conception and evaluation. Conclusions The experts agreed that web-based participatory interventions for youth sexual health promotion must be tailored to needs, uses, and preferences. This type of action requires youth involvement framed in an inclusive and holistic sexual health approach. Peer education can be implemented via the internet, but the design of the intervention also requires not being overly institutional in nature. Involving young people in their own education in an interactive, safe online space has the potential to develop their empowerment and to foster long-term positive behaviors, especially in the area of sexual health.
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Affiliation(s)
- Philippe Martin
- Institut National de la Santé Et de la Recherche Médicale (INSERM), Epidémiologie clinique et évaluation économique appliquées aux populations vulnérables (ECEVE), Université de Paris, Paris, France.,Institut National d'Etudes Démographiques (INED), UR14 - Sexual and Reproductive Health and Rights, Aubervilliers, France.,Centre de Recherche en épidémiologie et Santé des Populations (CESP) - UMR U1018 (UVSQ/INSERM), Université Paris-Saclay, Université Paris-Sud, Villejuif, France.,GDID Santé, Paris, France
| | - Corinne Alberti
- Institut National de la Santé Et de la Recherche Médicale (INSERM), Epidémiologie clinique et évaluation économique appliquées aux populations vulnérables (ECEVE), Université de Paris, Paris, France
| | | | - Aurelie Bourmaud
- Institut National de la Santé Et de la Recherche Médicale (INSERM), Epidémiologie clinique et évaluation économique appliquées aux populations vulnérables (ECEVE), Université de Paris, Paris, France
| | - Elise de La Rochebrochard
- Institut National d'Etudes Démographiques (INED), UR14 - Sexual and Reproductive Health and Rights, Aubervilliers, France.,Centre de Recherche en épidémiologie et Santé des Populations (CESP) - UMR U1018 (UVSQ/INSERM), Université Paris-Saclay, Université Paris-Sud, Villejuif, France
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12
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Demont A, Quentin J, Bourmaud A. [Impact of models of care integrating direct access to physiotherapy in primary care and emergency care contexts in patients with musculoskeletal disorders: A narrative review]. Rev Epidemiol Sante Publique 2020; 68:306-313. [PMID: 32893028 DOI: 10.1016/j.respe.2020.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 01/28/2020] [Revised: 06/08/2020] [Accepted: 08/01/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Musculoskeletal disorders are increasing in prevalence, principally due to sedentary behaviors. Strong evidence supports an early need for first-line treatment including physiotherapy. New and innovative models in primary and emergency care have been drawn up and put the physiotherapist's skills to work in early and first-line management of patients with musculoskeletal disorders. The objectives of this review were to identify and describe studies assessing models of care integrating direct access to physiotherapy in primary care and in emergency care for patients with musculoskeletal disorders and to provide perspectives on the application of these two models in France. METHODS A literature review was carried out including studies extracted from four scientific databases: PubMed, CINAHL, Embase, and PEDro. The selected articles had to address the clinical effectiveness or efficiency of these models for the provision of care in primary or in emergency care. A narrative literature review method was used. The synthesis deals with the qualitative analysis of the included studies. RESULTS Thirty-nine studies were included in this review: 19 on assessment of the direct access to physiotherapy model in primary care and 20 on the direct access to physiotherapy model in emergency departments as concerns patients with musculoskeletal disorders. The studies showed that the different models incorporating direct access to physiotherapy in primary or in emergency care provided better outcomes in terms of quality and access to care while maintaning a similar degree of safety. However, the methodology of the studies included was estimated as being of heterogeneous quality. CONCLUSION The studies dealing with the new models for provision of care integrating direct access to physiotherapy in primary care or emergency care impart two lessons: (1) they are not designed to replace the physician; (2) collaboration between different health professionals aimed at improving patients' access to efficient care is to be encouraged. It would be worthwhile to focus upon dissemination factors that would enhance the efficiency of these innovative models in other countries, as in France.
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Affiliation(s)
- A Demont
- Inserm 1123 ECEVE, faculté de médecine, université Paris-Diderot, Paris, France; École universitaire de kinésithérapie, université d'Orléans, Orléans, France.
| | - J Quentin
- Pôle Saint-Hélier, centre de médecine physique et réadaptation, Rennes, France
| | - A Bourmaud
- Inserm 1123 ECEVE, faculté de médecine, université Paris-Diderot, Paris, France
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Martin P, Cousin L, Gottot S, Bourmaud A, de La Rochebrochard E, Alberti C. Participatory Interventions for Sexual Health Promotion for Adolescents and Young Adults on the Internet: Systematic Review. J Med Internet Res 2020; 22:e15378. [PMID: 32735217 PMCID: PMC7428916 DOI: 10.2196/15378] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 11/06/2019] [Accepted: 02/22/2020] [Indexed: 01/14/2023] Open
Abstract
Background The World Health Organization recommends the development of participatory sexuality education. In health promotion, web-based participatory interventions have great potential in view of the internet’s popularity among young people. Objective The aim of this review is to describe existing published studies on online participatory intervention methods used to promote the sexual health of adolescents and young adults. Methods We conducted a systematic review based on international scientific and grey literature. We used the PubMed search engine and Aurore database for the search. Articles were included if they reported studies on participatory intervention, included the theme of sexual health, were conducted on the internet (website, social media, online gaming system), targeted populations aged between 10 and 24 years, and had design, implementation, and evaluation methods available. We analyzed the intervention content, study implementation, and evaluation methods for all selected articles. Results A total of 60 articles were included, which described 37 interventions; several articles were published about the same intervention. Process results were published in many articles (n=40), in contrast to effectiveness results (n=23). Many of the 37 interventions were developed on websites (n=20). The second most used medium is online social networks (n=13), with Facebook dominating this group (n=8). Online peer interaction is the most common participatory component promoted by interventions (n=23), followed by interaction with a professional (n=16). Another participatory component is game-type activity (n=10). Videos were broadcast for more than half of the interventions (n=20). In total, 43% (n=16) of the interventions were based on a theoretical model, with many using the Information-Motivation-Behavioral Skills model (n=7). Less than half of the interventions have been evaluated for effectiveness (n=17), while one-third (n=12) reported plans to do so and one-fifth (n=8) did not indicate any plan for effectiveness evaluation. The randomized controlled trial is the most widely used study design (n=16). Among the outcomes (evaluated or planned for evaluation), sexual behaviors are the most evaluated (n=14), followed by condom use (n=11), and sexual health knowledge (n=8). Conclusions Participatory online interventions for young people’s sexual health have shown their feasibility, practical interest, and attractiveness, but their effectiveness has not yet been sufficiently evaluated. Online peer interaction, the major participatory component, is not sufficiently conceptualized and defined as a determinant of change or theoretical model component. One potential development would be to build a conceptual model integrating online peer interaction and support as a component.
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Affiliation(s)
- Philippe Martin
- Université de Paris, ECEVE, INSERM, Paris, France.,Institut National d'Etudes Démographiques, UR14 - Sexual and Reproductive Health and Rights, Paris, France.,Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Le Kremlin Bicetre, France.,GDID Santé, Paris, France
| | | | | | | | - Elise de La Rochebrochard
- Institut National d'Etudes Démographiques, UR14 - Sexual and Reproductive Health and Rights, Paris, France.,Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Le Kremlin Bicetre, France
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14
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Fiorina L, Marijon E, Maupain C, Coquard C, Larnier L, Rischard J, Bourmaud A, Salerno F, Horvilleur J, Lacotte J, Ait Said M, Manenti V, Maltret A, Li J, Gardella C. 222AI-based strategy enables faster Holter ECG analysis with equivalent clinical accuracy compared to a classical strategy. Europace 2020. [DOI: 10.1093/europace/euaa162.374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND
Analysis of Holter recordings can be challenging and time-consuming, therefore requiring significant clinical resources in order to achieve a high-quality diagnosis. Such resources depend largely on the qualifications of the person conducting the analysis and the duration of the recordings. A novel Holter analysis platform has been developed, based on deep neural networks trained with a dataset of one million ECGs, to allow fast and reliable Holter recording analysis.
PURPOSE
This study sought to compare the performance of an artificial intelligence (AI)-based Holter analysis platform using deep learning tools with a classical one used on a daily basis in hospitals (the reference). The main endpoints evaluated were duration to complete the analysis by the physician operating it as well as diagnostic accuracy of each strategy, when platforms are used by electrophysiologists (EPs).
METHODS
For this prospective evaluation, a total of 159 Holter recordings (24-hour) were selected from a large Holter dataset from 1 hospital, with a relatively high prevalence of electrical rhythm and conduction disorders. Recordings were analysed by four EPs using independently both the AI-based and classical analysis platforms. All four EPs had no previous experience with the AI-based platform, except for an introductory 6-hour training session. Three EPs had multiple years of experience with the traditional platform, while one EP had limited experience. For each recording, in addition to the analysis duration, diagnostic accuracy was evaluated through the analysis of the presence or absence of predefined cardiac arrhythmias and conduction disorders (prevalence): pauses (25.2%), ventricular tachycardia (VT, 30.2%), atrial fibrillation (AF, 26.4%), high grade atrioventricular block (AVB, 10.1%) and burden of premature ventricular complex larger than 10% (PVC, 23.9%). Definite diagnostics were established by an expert EP after a careful examination of all available analysis reports.
RESULTS
Time required for the AI-based analysis was on average 42% shorter compared to the traditional platform (6.65 min vs 11.5 min, p < 0.0001). Regarding accuracy to detect electrical disorders, there was no statistically significant differences between AI-based and classical platforms (AF: 98.7% vs 96.9%, Pause: 99.4% vs 100%, PVC: 98.7% vs 98.7%, VT: 92.5% vs 96.2%, AVB: 98.7% vs 94.3%). CONCLUSION: These preliminary findings suggest that an AI-based strategy to analyse Holter recordings may be highly accurate in detecting cardiac electrical abnormalities, with significant time savings compared to a classical strategy, even for users with no previous experience with the novel AI-based platform. An AI-based Holter analysis platform may contribute to a broader and more resource-efficient adoption of Holter monitoring.
Abstract Figure. analysis duration using each strategy
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Affiliation(s)
- L Fiorina
- Cardiovascular Institute Paris-Sud (ICPS), Massy, France
| | - E Marijon
- European Hospital Georges Pompidou, Cardiology, Paris, France
| | - C Maupain
- PITIE SALPETRIERE APHP UNIVERSITY HOSPITAL, electrophysiology, Paris, France
| | - C Coquard
- Cardiovascular Institute Paris-Sud (ICPS), Massy, France
| | - L Larnier
- PITIE SALPETRIERE APHP UNIVERSITY HOSPITAL, electrophysiology, Paris, France
| | - J Rischard
- European Hospital Georges Pompidou, Cardiology, Paris, France
| | - A Bourmaud
- University Paris Diderot , Paris, France
| | - F Salerno
- Cardiovascular Institute Paris-Sud (ICPS), Massy, France
| | - J Horvilleur
- Cardiovascular Institute Paris-Sud (ICPS), Massy, France
| | - J Lacotte
- Cardiovascular Institute Paris-Sud (ICPS), Massy, France
| | - M Ait Said
- Cardiovascular Institute Paris-Sud (ICPS), Massy, France
| | - V Manenti
- Cardiovascular Institute Paris-Sud (ICPS), Massy, France
| | - A Maltret
- Cardiovascular Institute Paris-Sud (ICPS), Massy, France
| | - J Li
- Cardiologs Techologies, Paris, France
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Demont A, Bourmaud A, Kechichian A, Desmeules F. Direct access physiotherapy for patients with musculoskeletal disorders: a systematic review. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.335] [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
Although the benefits of physiotherapy is well supported in the literature, the impact of having direct access to physiotherapy is not well established. Update of the current available evidence is warranted. The aim of this systematic review was to update the current evidence regarding the impact of direct access physiotherapy compared to usual care for patients with musculoskeletal disorders.
Methods
Systematic searches were conducted in 5 bibliographic databases up until May 2018. Two independent raters reviewed studies and used the Quality Assessment Tool for Quantitative Studies to conduct the methodological quality assessment and a data extraction regarding patient outcomes, adverse events, health care utilization and processes, patient satisfaction and health care costs.
Results
Sixteen studies of weak to moderate quality were included. Five studies found no significant differences in pain reduction between usual family physician led care and direct access physiotherapy. However, three studies reported better clinical outcomes in patients with direct access in terms of function and quality of life. Five studies did not observe any adverse events with direct access physiotherapy. Three studies showed shorter waiting time and four studies reported fewer number of physiotherapy visits with direct access. Three studies showed that patients with direct access were less likely to have medication and imaging tests prescribed compared to usual care. Five studies reported higher levels of satisfaction for direct access. In terms of health care costs, four studies demonstrated that costs were lower with direct access and one study reported similar costs between both types of care.
Conclusions
Emerging evidence, although of weak to moderate quality, suggest that direct access physiotherapy provides equal or better outcomes than family physician led care models for musculoskeletal disorders patients. More methodologically strong studies are needed.
Key messages
This review supports the efficacy, safety and cost-effectiveness of direct access PT, while increasing access to care with a more efficient use of resources. There is a need for more methodologically strong studies to evaluate the efficiency of direct access models of care of physiotherapy for patients with MSKD.
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Affiliation(s)
- A Demont
- INSERM 1123 ECEVE, Faculty of Medicine, University of Paris-Diderot, Paris, France
| | - A Bourmaud
- INSERM 1123 ECEVE, Faculty of Medicine, University of Paris-Diderot, Paris, France
| | - A Kechichian
- University of Sorbonne, Pierre and Marie Curie, Paris, France
| | - F Desmeules
- Physiotherapy School, University of Montreal Affiliated Research Center, Montréal, Canada
- Maisonneuve-Rosemont Hospital Research Center, Montréal, Canada
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16
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Darmon M, Bourmaud A, Reynaud M, Rouleau S, Meziani F, Boivin A, Benyamina M, Vincent F, Lautrette A, Leroy C, Cohen Y, Legrand M, Morel J, Terreaux J, Schnell D. Performance of Doppler-based resistive index and semi-quantitative renal perfusion in predicting persistent AKI: results of a prospective multicenter study. Intensive Care Med 2018; 44:1904-1913. [PMID: 30291377 DOI: 10.1007/s00134-018-5386-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 09/21/2018] [Indexed: 12/20/2022]
Abstract
PURPOSE The Doppler-based resistive index (RI) and semi-quantitative evaluation of renal perfusion using color Doppler (SQP) have shown promising results for predicting persistent acute kidney injury (AKI) in preliminary studies. This study aimed at evaluating the performance of RI and SQP to predict short-term renal prognosis in critically ill patients. METHODS Prospective multicenter cohort study including unselected critically ill patients. Renal Doppler was performed at admission to the intensive care unit. The diagnostic performance of RI and SQP to predict persistent AKI at day 3 was evaluated. RESULTS Overall, 371 patients were included, of whom 351 could be assessed for short-term renal recovery. Two thirds of the included patients had AKI (n = 233; 66.3%), of whom 136 had persistent AKI (58.4%). Doppler-based RI was higher and SQP lower in AKI patients and according to AKI recovery. Overall performance in predicting persistent AKI was however poor with area under ROC curve of respectively 0.58 (95% CI 0.52-0.64) and 0.59 (95% CI 0.54-0.65) for RI and SQP. Optimal cutoff was respectively 0.71 and 2 for RI and SQP. At optimal cutoff, sensitivity and specificity were 50% (95% CI 41-58%) and 68% (62-74%) for RI and 39% (32-45%) and 75% (66-82%) for SQP. CONCLUSION Although statistically associated with AKI occurrence, RI and SQP perform poorly in predicting persistent AKI at day 3. Further studies are needed to adequately describe factors influencing Doppler-based assessment of renal perfusion and to delineate whether these indicators may be useful at the bedside. CLINICALTRIAL.GOV: NCT02355314.
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Affiliation(s)
- Michael Darmon
- Medical ICU, Saint-Louis University Hospital, AP-HP, 1 Avenue Claude Vellefaux, 75010, Paris, France. .,Faculté de Médecine, Université Paris-Diderot, Sorbonne-Paris-Cité, Paris, France. .,ECSTRA Team, Biostatistics and Clinical Epidemiology, UMR 1153 (Center of Epidemiology and Biostatistic, Sorbonne Paris Cité, CRESS), INSERM, Paris, France.
| | - Aurelie Bourmaud
- Hygée Centre and Public Health Department, Lucien Neuwirth Cancerology Institute, Saint-Priest-En-Jarez, France
| | - Marie Reynaud
- Surgical ICU, Saint-Etienne University Hospital, Saint-Etienne, France
| | | | - Ferhat Meziani
- Faculté de Médecine, Service de Réanimation, Université de Strasbourg (UNISTRA), Hôpitaux Universitaires de Strasbourg, Nouvel Hôpital Civil, Strasbourg, France.,INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, Strasbourg, France
| | - Alexandra Boivin
- Faculté de Médecine, Service de Réanimation, Université de Strasbourg (UNISTRA), Hôpitaux Universitaires de Strasbourg, Nouvel Hôpital Civil, Strasbourg, France
| | - Mourad Benyamina
- Surgical ICU and Burn Unit, Saint-Louis University Hospital, AP-HP, Paris, France
| | - François Vincent
- Medical Surgical ICU, GHIC Le Raincy-Montfermeil, 93370, Montfermeil, France
| | - Alexandre Lautrette
- Intensive Care Unit, Gabriel Montpied Hospital, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Christophe Leroy
- Intensive Care Unit, Gabriel Montpied Hospital, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Yves Cohen
- Medical-Surgical ICU, Avicenne University Hospital, AP-HP, Paris, France
| | - Matthieu Legrand
- Faculté de Médecine, Université Paris-Diderot, Sorbonne-Paris-Cité, Paris, France.,Surgical ICU and Burn Unit, Saint-Louis University Hospital, AP-HP, Paris, France
| | - Jérôme Morel
- Surgical ICU, Saint-Etienne University Hospital, Saint-Etienne, France.,Saint-Etienne University, Jacques Lisfranc Medical School, Saint-Etienne, France
| | - Jeremy Terreaux
- Medical-Surgical ICU, Saint-Etienne University Hospital, Saint-Etienne, France.,Cardiology Unit, Saint-Etienne University Hospital, Saint-Etienne, France
| | - David Schnell
- Medical-Surgical ICU, Angoulême Hospital, Angoulême, France.,Faculté de Médecine, Service de Réanimation, Université de Strasbourg (UNISTRA), Hôpitaux Universitaires de Strasbourg, Nouvel Hôpital Civil, Strasbourg, France
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17
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Decousus H, Bertoletti L, Fournel P, Bourmaud A, Labruyère C, Presles E, Merah A, Laporte S, Stefani L, Landry G, Chauvin F, Meyer G. In patients with cancer, prognostic factors of catheter-related thrombosis (CRT) are different than prognostic factors of VTE. A prospective cohort study in 3032 cancer patients with central venous catheter (ONCOCIP). Thromb Res 2018. [DOI: 10.1016/j.thromres.2018.02.080] [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: 11/16/2022]
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18
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Bourmaud A, Soler-Michel P, Oriol M, Regnier V, Tinquaut F, Nourissat A, Bremond A, Moumjid N, Chauvin F. Decision aid on breast cancer screening reduces attendance rate: results of a large-scale, randomized, controlled study by the DECIDEO group. Oncotarget 2017; 7:12885-92. [PMID: 26883201 PMCID: PMC4914328 DOI: 10.18632/oncotarget.7332] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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: 10/30/2015] [Accepted: 01/27/2016] [Indexed: 11/25/2022] Open
Abstract
Controversies regarding the benefits of breast cancer screening programs have led to the promotion of new strategies taking into account individual preferences, such as decision aid. The aim of this study was to assess the impact of a decision aid leaflet on the participation of women invited to participate in a national breast cancer screening program. This Randomized, multicentre, controlled trial. Women aged 50 to 74 years, were randomly assigned to receive either a decision aid or the usual invitation letter. Primary outcome was the participation rate 12 months after the invitation. 16 000 women were randomized and 15 844 included in the modified intention-to-treat analysis. The participation rate in the intervention group was 40.25% (3174/7885 women) compared with 42.13% (3353/7959) in the control group (p = 0.02). Previous attendance for screening (RR = 6.24; [95%IC: 5.75-6.77]; p < 0.0001) and medium household income (RR = 1.05; [95%IC: 1.01-1.09]; p = 0.0074) were independently associated with attendance for screening. This large-scale study demonstrates that the decision aid reduced the participation rate. The decision aid activate the decision making process of women toward non-attendance to screening. These results show the importance of promoting informed patient choices, especially when those choices cannot be anticipated.
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Affiliation(s)
- Aurelie Bourmaud
- Hygée Centre, Lucien Neuwirth Cancer Institut, CIC-EC Inserm 1408, Saint Priest en Jarez, France.,EMR3738, Therapeutic Targeting in Oncology, Claude Bernard University, Lyon, France
| | - Patricia Soler-Michel
- Adémas-69, Association pour le Dépistage Organisé des Cancers dans le Rhône, Lyon, France
| | - Mathieu Oriol
- Hygée Centre, Lucien Neuwirth Cancer Institut, CIC-EC Inserm 1408, Saint Priest en Jarez, France.,Jean Monnet University, Saint-Etienne, France
| | - Véronique Regnier
- Hygée Centre, Lucien Neuwirth Cancer Institut, CIC-EC Inserm 1408, Saint Priest en Jarez, France
| | - Fabien Tinquaut
- Hygée Centre, Lucien Neuwirth Cancer Institut, CIC-EC Inserm 1408, Saint Priest en Jarez, France
| | - Alice Nourissat
- Hygée Centre, Lucien Neuwirth Cancer Institut, CIC-EC Inserm 1408, Saint Priest en Jarez, France
| | | | - Nora Moumjid
- Lyon 1 University, Lyon, France.,GATE-LSE UMR 5824 CNRS, Lyon, France.,Léon Bérard Cancer Centre, Lyon, France
| | - Franck Chauvin
- Hygée Centre, Lucien Neuwirth Cancer Institut, CIC-EC Inserm 1408, Saint Priest en Jarez, France.,EMR3738, Therapeutic Targeting in Oncology, Claude Bernard University, Lyon, France.,Jean Monnet University, Saint-Etienne, France
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19
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Laporte S, Chauvin F, Bourmaud A, Presles E. [Editorial]. Rev Epidemiol Sante Publique 2017; 65 Suppl 2:S45-S46. [PMID: 28372835 DOI: 10.1016/j.respe.2017.03.002] [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: 11/26/2022] Open
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20
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Bourmaud A, Anota A, Moncharmont C, Tinquaut F, Oriol M, Trillet-Lenoir V, Bajard A, Parnalland S, Rotonda C, Bonnetain F, Pérol D, Chauvin F. Cancer-related fatigue management: evaluation of a patient education program with a large-scale randomised controlled trial, the PEPs fatigue study. Br J Cancer 2017; 116:849-858. [PMID: 28196066 PMCID: PMC5379143 DOI: 10.1038/bjc.2017.31] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 12/23/2016] [Accepted: 01/21/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND To assess the efficacy of a patient educational program built according to guidelines that aims at reducing cancer-related fatigue (CRF). METHODS Randomised controlled trial, multicentre, comparing a patient education program, vs the standard of care. Patients were adult cancer outpatients with any tumour site. The primary outcome was fatigue severity assessed with a visual analogical scale (VAS), between the day of randomisation and week 7. Secondary outcomes were fatigue assessed with other scales, health-related quality of life, anxiety and depression. The time to fatigue severity deterioration was assessed. Analyses were performed in a modified intent-to-treat way, that is, including all patients with at least one baseline and 1 week 7 score. RESULTS A total of 212 patients were included. Fatigue severity assessment was made on 79 patients in the experimental group and 65 in the control group. Between randomisation and week 7, the fatigue (VAS) improved by 0.96 (2.85) points in the experimental group vs 1.63 (2.63) points in the control group (P=0.15). No differences with the secondary outcomes were highlighted between two groups. No other factors were found to be associated with fatigue severity deterioration. CONCLUSIONS Despite rigorous methodology, this study failed to highlight the program efficacy in fatigue reduction for cancer patients. Other assessment tools should be developed to measure the effect of the program on CRF and behaviour. The implementation of the program should also be explored in order to identify its mechanisms and longer-term impact.
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Affiliation(s)
- A Bourmaud
- Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France
- Quality Safety Performance in Health (HESPER) EA7425, Lyon 1 University, Lyon, France
- Inserm, Clinical Investigation Center 1408, Saint-Etienne 42055, France
| | - A Anota
- French National Platform Quality of Life and Cancer, Besançon, France
- Methodology and Quality of Life Unit in Cancer, INSERM UMR 1098, University Hospital of Besançon, Besançon, France
| | - C Moncharmont
- Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France
- Radiotherapy Department, Lucien Neuwirth Cancer Institut, Saint Priest en Jarez, France
| | - F Tinquaut
- Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France
- Inserm, Clinical Investigation Center 1408, Saint-Etienne 42055, France
| | - M Oriol
- Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France
- Inserm, Clinical Investigation Center 1408, Saint-Etienne 42055, France
| | - V Trillet-Lenoir
- Medical Oncology Department, Lyon-Sud Lyon-Sud teaching hospital, Lyon, France
| | - A Bajard
- Direction of Clinical Research and of Innovation, Léon Bérard Cancer Center, Lyon, France
| | - S Parnalland
- French National Platform Quality of Life and Cancer, Besançon, France
| | - C Rotonda
- French National Platform Quality of Life and Cancer, Besançon, France
- INSERM, CIC-EC CIE6, Nancy, France CHU Nancy, Clinical Epidemiology and Evaluation Department, Nancy, France
| | - F Bonnetain
- French National Platform Quality of Life and Cancer, Besançon, France
- Methodology and Quality of Life Unit in Cancer, INSERM UMR 1098, University Hospital of Besançon, Besançon, France
| | - D Pérol
- Direction of Clinical Research and of Innovation, Léon Bérard Cancer Center, Lyon, France
| | - F Chauvin
- Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France
- Quality Safety Performance in Health (HESPER) EA7425, Lyon 1 University, Lyon, France
- Inserm, Clinical Investigation Center 1408, Saint-Etienne 42055, France
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21
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Tavernier-Tardy E, Cornillon J, Molucon-Chabrot C, Cahn JY, Tinquaut F, Bourmaud A, Guyotat D, Thomas X. A phase 1/2 trial of lenalidomide and dexamethasone in adult patients with refractory/relapsed acute lymphoblastic leukemia. ACTA ACUST UNITED AC 2016; 22:217-223. [PMID: 27848278 DOI: 10.1080/10245332.2016.1255372] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Adult patients with refractory/relapsed ALL have poor survival outcomes with current chemotherapies. We aimed to determine safety and efficacy of lenalidomide, an oral immunomodulator, in these patients. METHODS This phase 1/2 trial (EUDRACT # 2009-009372-13) included 10 patients who received 28-day cycles of oral lenalidomide 25 mg/day, days 1 through 21, in combination with oral dexamethasone 40 mg/day on days 1, 8, 15, 22. Primary endpoints were tolerance and the overall response rate (ORR). Secondary endpoints included overall survival (OS) and quality of life. RESULTS The most common grade 3 or 4 adverse events were myelosuppression. The ORR among the participants who could be evaluated was 28.6% (95% confidence interval [CI], 0-62.2%). The median OS was 92 days (range, 43-133 days). All patients have died because of progressive disease. Quality of life remains stable during treatment cycles. DISCUSSION AND CONCLUSION The safety of combination therapy consisting of lenalidomide plus dexamethasone is consistent with ambulatory administration. Efficacy should be reevaluated in a larger series including patients less intensively previously treated.
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Affiliation(s)
- E Tavernier-Tardy
- a Hematology Unit , Institut de Cancérologie de la Loire , Saint Priest en Jarez , France
| | - J Cornillon
- a Hematology Unit , Institut de Cancérologie de la Loire , Saint Priest en Jarez , France
| | | | - J Y Cahn
- c Hematology Unit , CHU , Grenoble , France
| | - F Tinquaut
- d Public Health department , Institut de Cancérologie de la Loire , Saint Priest en Jarez , France
| | - A Bourmaud
- d Public Health department , Institut de Cancérologie de la Loire , Saint Priest en Jarez , France
| | - D Guyotat
- a Hematology Unit , Institut de Cancérologie de la Loire , Saint Priest en Jarez , France
| | - X Thomas
- e Hematology Unit , CHU Hospices Civils de Lyon , Lyon , France
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Terrier J, Bourmaud A, Chloé H, Chauvin F, Mottet N. Objectifs educationnels d’un programme d’éducation thérapeutique visant à gérer les effets secondaires de la suppression androgénique chez les patients atteints d’un cancer de la prostate : étude qualitative. Prog Urol 2016. [DOI: 10.1016/j.purol.2016.07.220] [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: 11/25/2022]
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23
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Rivoirard R, Duplay V, Oriol M, Tinquaut F, Chauvin F, Magne N, Bourmaud A. Outcomes Definitions and Statistical Tests in Oncology Studies: A Systematic Review of the Reporting Consistency. PLoS One 2016; 11:e0164275. [PMID: 27716793 PMCID: PMC5055310 DOI: 10.1371/journal.pone.0164275] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 09/22/2016] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Quality of reporting for Randomized Clinical Trials (RCTs) in oncology was analyzed in several systematic reviews, but, in this setting, there is paucity of data for the outcomes definitions and consistency of reporting for statistical tests in RCTs and Observational Studies (OBS). The objective of this review was to describe those two reporting aspects, for OBS and RCTs in oncology. METHODS From a list of 19 medical journals, three were retained for analysis, after a random selection: British Medical Journal (BMJ), Annals of Oncology (AoO) and British Journal of Cancer (BJC). All original articles published between March 2009 and March 2014 were screened. Only studies whose main outcome was accompanied by a corresponding statistical test were included in the analysis. Studies based on censored data were excluded. Primary outcome was to assess quality of reporting for description of primary outcome measure in RCTs and of variables of interest in OBS. A logistic regression was performed to identify covariates of studies potentially associated with concordance of tests between Methods and Results parts. RESULTS 826 studies were included in the review, and 698 were OBS. Variables were described in Methods section for all OBS studies and primary endpoint was clearly detailed in Methods section for 109 RCTs (85.2%). 295 OBS (42.2%) and 43 RCTs (33.6%) had perfect agreement for reported statistical test between Methods and Results parts. In multivariable analysis, variable "number of included patients in study" was associated with test consistency: aOR (adjusted Odds Ratio) for third group compared to first group was equal to: aOR Grp3 = 0.52 [0.31-0.89] (P value = 0.009). CONCLUSION Variables in OBS and primary endpoint in RCTs are reported and described with a high frequency. However, statistical tests consistency between methods and Results sections of OBS is not always noted. Therefore, we encourage authors and peer reviewers to verify consistency of statistical tests in oncology studies.
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Affiliation(s)
- Romain Rivoirard
- Department of Medical Oncology Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France
| | - Vianney Duplay
- Department of Public Health, Hygée Center, Saint Priest en Jarez, France
- Inserm, Clinical Investigation Center 1408, 42055 Saint-Etienne, France
| | - Mathieu Oriol
- Department of Public Health, Hygée Center, Saint Priest en Jarez, France
- Inserm, Clinical Investigation Center 1408, 42055 Saint-Etienne, France
| | - Fabien Tinquaut
- Department of Public Health, Hygée Center, Saint Priest en Jarez, France
- Inserm, Clinical Investigation Center 1408, 42055 Saint-Etienne, France
| | - Franck Chauvin
- Department of Public Health, Hygée Center, Saint Priest en Jarez, France
- Inserm, Clinical Investigation Center 1408, 42055 Saint-Etienne, France
| | - Nicolas Magne
- Department of Radiation Therapy Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France
| | - Aurelie Bourmaud
- Department of Public Health, Hygée Center, Saint Priest en Jarez, France
- Inserm, Clinical Investigation Center 1408, 42055 Saint-Etienne, France
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Dominique I, Bourmaud A, Tamarelle B, Terrier JE, Ruffion A. [Patient information before bladder wall injection of botulinum toxin A (Botox ®): Which essential items? Results of Delphi consensus from GENULF experts]. Prog Urol 2016; 26:1206-1212. [PMID: 27647649 DOI: 10.1016/j.purol.2016.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 05/01/2016] [Revised: 08/03/2016] [Accepted: 08/11/2016] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Preoperative information before bladder wall injection of botulinum toxin A (Botox®) holds several essential facts to understand and retain by the patients. The aim of this study was a review of essential preoperative information items according to GENULF medical experts. METHOD It was a prospective review from December 2015 to April 2016. Three Delphi rounds had been done from the Survey Monkey® software. The initial questionnaire was composed of items from the patient information sheet edited by the GENULF. Each item had been rated by the medical expert on a numeric scale of importance for patient information. The last round asked to experts to confirm items eventually selected. RESULTS A list of 27 items regarded as essentials for patient information had been checked by experts after three Delphi rounds, confirmed by 15/19 experts (75%). Best rated items were "learning self-catheterisation is essential" (mean interest 8,5/9 ; number of rate 8 or 9: 15), "kidney are protected over the long term" (mean interest 8,3/9 ; number of rate 8 or 9: 15), "efficiency is 6 to 9 months long" (mean interest 8,2/9 ; number of rate 8 or 9: 14). Discrepancies were mostly on lack of distinction between neurologic and non-neurologic patients. CONCLUSION We identified accurate items considered as essential for preoperative information to patients before bladder wall injection of botulinum toxin A (Botox®) by a Delphi method recommended by HAS. LEVEL OF EVIDENCE 4.
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Affiliation(s)
| | - A Bourmaud
- Centre hygée - centre régional de prévention des cancers, Institut de cancérologie Lucien-Neuwirth, 42270 Saint-Priest-en-Jarez, France.
| | | | | | - A Ruffion
- CHU Lyon Sud, 69310 Pierre-Bénite, France.
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Allary C, Bourmaud A, Tinquaut F, Lechopier N, Buthion V, Chauvin F. COLONAV - Navigateur de patients pour le dépistage du cancer colorectal dans les zones défavorisées. Rev Epidemiol Sante Publique 2016. [DOI: 10.1016/j.respe.2016.06.044] [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: 10/21/2022] Open
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Allary C, Bourmaud A, Tinquaut F, Oriol M, Kalecinski J, Dutertre V, Lechopier N, Pommier M, Benoist Y, Rousseau S, Regnier V, Buthion V, Chauvin F. ColoNav: patient navigation for colorectal cancer screening in deprived areas - Study protocol. BMC Cancer 2016; 16:416. [PMID: 27388807 PMCID: PMC4936239 DOI: 10.1186/s12885-016-2469-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 01/06/2016] [Accepted: 06/29/2016] [Indexed: 01/22/2023] Open
Abstract
Background The mass colorectal cancer screening program was implemented in 2008 in France, targeting 16 million French people aged between 50 and 74. The current adhesion is insufficient and the participation rate is even lower among the underserved population, increasing health inequalities within our health care system. Patient Navigation programs have proved their efficiency to promote the access to cancer screening and diagnosis. Methods/Design The purpose of the study is to assess the implementation of a patient navigation intervention that has been described in another cultural environment and another health care system. The main objective of the program is to increase the colorectal cancer screening participation rate among the deprived population through the intervention of a navigator to promote the Fecal Occult Blood Test (FOBT) and complementary exams. We performed a multisite cluster randomized controlled trial, with three groups (one experimental group and two control groups) for 18 months. Discussion The study attempts to give a better understanding of the adhesion barriers to colorectal cancer screening among underserved populations. If this project is cost-effective, it could create a dynamic based on peer approaches that could be developed for other cancer screening programs and other chronic diseases. Trial registration NCT02369757
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Affiliation(s)
- C Allary
- Hygée Centre, Lucien Neuwirth Cancer Institut- ICLN, CIC 1408 INSERM, 108bis avenue A. Raimond, 42270, Saint-Priest-en-Jarez, France
| | - A Bourmaud
- Hygée Centre, Lucien Neuwirth Cancer Institut- ICLN, CIC 1408 INSERM, 108bis avenue A. Raimond, 42270, Saint-Priest-en-Jarez, France.
| | - F Tinquaut
- Hygée Centre, Lucien Neuwirth Cancer Institut- ICLN, CIC 1408 INSERM, 108bis avenue A. Raimond, 42270, Saint-Priest-en-Jarez, France
| | - M Oriol
- Hygée Centre, Lucien Neuwirth Cancer Institut- ICLN, CIC 1408 INSERM, 108bis avenue A. Raimond, 42270, Saint-Priest-en-Jarez, France
| | - J Kalecinski
- Hygée Centre, Lucien Neuwirth Cancer Institut- ICLN, CIC 1408 INSERM, 108bis avenue A. Raimond, 42270, Saint-Priest-en-Jarez, France
| | - V Dutertre
- Hygée Centre, Lucien Neuwirth Cancer Institut- ICLN, CIC 1408 INSERM, 108bis avenue A. Raimond, 42270, Saint-Priest-en-Jarez, France
| | - N Lechopier
- EA 4148 - S2HEP, University Lyon 1/Ecole Normale Supérieure de Lyon, 43, Boulevard du 11 novembre 1918, 69622, Villeurbanne cedex, France
| | - M Pommier
- EA 4148 - S2HEP, University Lyon 1/Ecole Normale Supérieure de Lyon, 43, Boulevard du 11 novembre 1918, 69622, Villeurbanne cedex, France
| | - Y Benoist
- Gustave Roussy Institut, 114 rue Edouard Vaillant, 94800, Villejuif, France
| | - S Rousseau
- Gustave Roussy Institut, 114 rue Edouard Vaillant, 94800, Villejuif, France
| | - V Regnier
- Hygée Centre, Lucien Neuwirth Cancer Institut- ICLN, CIC 1408 INSERM, 108bis avenue A. Raimond, 42270, Saint-Priest-en-Jarez, France
| | - V Buthion
- COACTIS, Lumière University Lyon 2, 16 avenue Berthelot, 69007, Lyon, France
| | - F Chauvin
- Hygée Centre, Lucien Neuwirth Cancer Institut- ICLN, CIC 1408 INSERM, 108bis avenue A. Raimond, 42270, Saint-Priest-en-Jarez, France
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Molins E, Tinquaut F, Oriol M, Rousset V, Okala J, Fournel P, Collard O, Chauvin F, Bourmaud A. Pourquoi les patients refusent-ils de participer à l’éducation thérapeutique ? Une approche mixte pour expliquer le biais d’auto-sélection. Rev Epidemiol Sante Publique 2016. [DOI: 10.1016/j.respe.2016.03.037] [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: 11/26/2022] Open
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Desgranges P, Kobeiter H, Katsahian S, Bouffi M, Gouny P, Favre JP, Alsac J, Sobocinski J, Julia P, Alimi Y, Steinmetz E, Haulon S, Alric P, Canaud L, Castier Y, Jean-Baptiste E, Hassen-Khodja R, Lermusiaux P, Feugier P, Destrieux-Garnier L, Charles-Nelson A, Marzelle J, Majewski M, Bourmaud A, Becquemin JP. ECAR (Endovasculaire ou Chirurgie dans les Anévrysmes aorto-iliaques Rompus): A French Randomized Controlled Trial of Endovascular Versus Open Surgical Repair of Ruptured Aorto-iliac Aneurysms. J Vasc Surg 2015. [DOI: 10.1016/j.jvs.2015.07.061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Desgranges P, Kobeiter H, Katsahian S, Bouffi M, Gouny P, Favre JP, Alsac J, Sobocinski J, Julia P, Alimi Y, Steinmetz E, Haulon S, Alric P, Canaud L, Castier Y, Jean-Baptiste E, Hassen-Khodja R, Lermusiaux P, Feugier P, Destrieux-Garnier L, Charles-Nelson A, Marzelle J, Majewski M, Bourmaud A, Becquemin JP. Editor's Choice – ECAR (Endovasculaire ou Chirurgie dans les Anévrysmes aorto-iliaques Rompus): A French Randomized Controlled Trial of Endovascular Versus Open Surgical Repair of Ruptured Aorto-iliac Aneurysms. Eur J Vasc Endovasc Surg 2015; 50:303-10. [DOI: 10.1016/j.ejvs.2015.03.028] [Citation(s) in RCA: 128] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 03/12/2015] [Indexed: 12/15/2022]
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Soccalingame L, Bourmaud A, Perrin D, Bénézet JC, Bergeret A. Reprocessing of wood flour reinforced polypropylene composites: Impact of particle size and coupling agent on composite and particle properties. Polym Degrad Stab 2015. [DOI: 10.1016/j.polymdegradstab.2015.01.020] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Bourmaud A, Tinquaut F, Regnier V, Rousset V, Henin E, Chauvin F. Les facteurs de non-adhésion aux traitements oraux chez les patients de cancérologie, Saint-Étienne, France. Rev Epidemiol Sante Publique 2014. [DOI: 10.1016/j.respe.2014.06.139] [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: 11/16/2022] Open
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Bourmaud A, Hénin E, Tinquaut F, Regnie V, Hamant C, Freyer G, Tod M, Rioufol C, Trillet-Lenoir V, Chauvin F. Observance d’une chimiothérapie orale : identification des profils de patientes grâce à une analyse des correspondances multiples et des entretiens (Étude OCTO-SOCIO). Rev Epidemiol Sante Publique 2014. [DOI: 10.1016/j.respe.2014.05.073] [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] Open
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Abstract
Targeted proteomics has emerged as the predominant method for quantitative analyses of peptides to complement shotgun LC/MS studies. Targeted measurements are routinely performed using the technique of selected reaction monitoring (SRM) on triple quadrupole instruments. However, the approach suffers from limitations inherent to the SRM technique. First, the selectivity of measurements is often insufficient to effectively discriminate the analytes from the complex background commonly encountered in biological samples. Second, the number of peptides analyzed in one experiment remains limited. The recent development of high resolution/accurate mass instruments, in conjunction with various acquisition methods, has opened new avenues for quantitative proteomic studies. An overview of the analytical capabilities of a high resolution hybrid quadrupole–orbitrap instrument for quantitative applications is presented and discussed in this chapter. The measurements are performed either on precursor ions (selected ion monitoring mode) or on fragment ions (parallel reaction monitoring mode), which overcome, in many instances, the selectivity issue encountered in complex samples, as illustrated on various examples. It clearly demonstrates the potential of high resolution mass measurements for quantitative proteomic applications.
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Affiliation(s)
- A. Bourmaud
- Luxembourg Clinical Proteomics Center (LCP) CRP-Santé, Strassen Luxembourg
| | - S. Gallien
- Luxembourg Clinical Proteomics Center (LCP) CRP-Santé, Strassen Luxembourg
| | - B. Domon
- Luxembourg Clinical Proteomics Center (LCP) CRP-Santé, Strassen Luxembourg
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Bourmaud A, Pacaut C, Melis A, Tinquaut F, Magné N, Merrouche Y, Chauvin F. Is oral chemotherapy prescription safe for patients? A cross-sectional survey. Ann Oncol 2014; 25:500-4. [PMID: 24406423 DOI: 10.1093/annonc/mdt553] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Oral chemotherapies are increasingly prescribed. Yet wide variations in prescription practices and in monitoring of toxicity have been underlined despite existing guidelines. There is little recent information available as regard to these practices. We aimed to obtain exhaustive information on oral chemotherapy prescription practices and safety monitoring in French hospitals. METHODS A cross-sectional multicentre survey was carried out to collect information on drug prescription, administration and surveillance: prescribing practices, coordination and monitoring of adherence, safety monitoring and side-effects occurrence prevention. Participants were a large sample of the French oncologists prescribing oral chemotherapy (20%). RESULTS One hundred and fifty-seven oncologists from 112 hospitals (public, comprehensive cancer centres and private) replied (23.7% of cancer hospitals). The majority (56.1%) of the prescriptions were hand-written on a blank sheet. Eighty-four physicians (53.5%) included dose information and 36 (23%) declared having no monitoring procedures for adherence. Only 84 responders (54%) provided education material at first prescription of oral chemotherapy in way to limit avoidable side-effects. Sixty-one (39%) responders stated that they recalled at least one serious adverse event in the previous year declared in their centre. CONCLUSIONS In this 2012 study, the majority of prescribers followed no standards in prescription writing, safety monitoring and toxicity prevention. The implementation of the international recommendations for oral chemotherapy administration should be considered as a top priority-for both prescribers and health authorities-as regards to the dynamic of development of these molecules and their potential side-effects.
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Affiliation(s)
- A Bourmaud
- Department of Public Health, Hygée Centre, Lucien Neuwirth Cancer Institut, Saint Priest en Jarez
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Darmon M, Bourmaud A, Vincent F. Urate oxidase should remain mandatory in patients at high risk of tumor lysis syndrome. Am J Kidney Dis 2013; 63:165-6. [PMID: 24360225 DOI: 10.1053/j.ajkd.2013.06.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 06/05/2013] [Indexed: 11/11/2022]
Affiliation(s)
| | - Aurelie Bourmaud
- Institut de Cancérologie Lucien Neuwirth, Saint-Priest-en-Jarrez, France
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Rousset V, Bourmaud A, Lataillade L, Lapoirie J, Jacquin JP, Chauvin F. Programme « Hormonothérapie » : du diagnostic éducatif à l’évaluation, Saint-Étienne, France. Rev Epidemiol Sante Publique 2013. [DOI: 10.1016/j.respe.2013.07.013] [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: 11/28/2022] Open
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Mokart D, Azoulay E, Schnell D, Bourmaud A, Kouatchet A, Pène F, Lemiale V, Lambert J, Bruneel F, Vincent F, Legrand M, Rabbat A, Darmon M. Acute respiratory failure in neutropenic patients is associated with a high post-ICU mortality. Minerva Anestesiol 2013; 79:1156-1163. [PMID: 23857442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Few studies have evaluated outcomes of neutropenic patients admitted to the ICU at the onset of acute respiratory failure (ARF). The main objective of this study was to describe outcomes and to identify early predictors of hospital mortality in critically ill cancer patients with ARF during chemotherapy-induced neutropenia. METHODS Retrospective analysis of prospectively collected data extracted from two recent prospective multicentre studies. We included neutropenic adults admitted to the ICU for ARF. RESULTS Of the 123 study patients, 107 patients (87%) had haematological malignancies; 78 (64%) were male, median age was 57 years (44-62), and median LOD score at ICU admission was 6 (4-9). ICU and hospital mortality rates were 42% and 77%, respectively. Endotracheal mechanical ventilation was an independent risk factor for hospital mortality (odds ratio [OR], 7.73; 95% confidence interval [95%CI], 2.52-23.69); two factors independently protected from hospital mortality, namely, ICU admission for ARF during neutropenia recovery (OR, 0.23; 95%CI, 0.07-0.73) and steroid therapy before ICU admission (OR, 0.35; 95%CI, 0.11-0.95). CONCLUSION Our study demonstrates a meaningful ICU survival in the studied population and identified factors associated with ICU and hospital mortality. Further work is needed to address the reasons for the high post-ICU mortality rate after ARF.
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Affiliation(s)
- D Mokart
- Medical-Surgical ICU, Paoli-Calmettes Institute, Marseille, France -
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Bourmaud A, Régnier-Denois V, Rousset V, Chauvin F. Premier pas d’un programme d’éducation thérapeutique : l’étude de faisabilité, Saint-Étienne, France. Rev Epidemiol Sante Publique 2013. [DOI: 10.1016/j.respe.2013.07.314] [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: 10/26/2022] Open
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Bourmaud A, Pérol D, Annota A, Trillet-Lenoir V, Bajard A, Parnalland S, Bonnetain F, Chauvin F. Éducation thérapeutique du patient – résultats d’un essai d’intervention randomisé multicentrique, Saint-Étienne, France. Rev Epidemiol Sante Publique 2013. [DOI: 10.1016/j.respe.2013.07.312] [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: 11/16/2022] Open
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Henin E, Bourmaud A, Colomban O, Schwiertz V, Regnier V, You B, Ranchon F, Guitton J, Maraval-Gaget R, Girard P, Chauvin F, Freyer G, Tod M, Rioufol C, Trillet-Lenoir VN. Patient compliance to oral anticancer chemotherapy evaluated in breast and colorectal cancer patients receiving capecitabine: The OCTO study. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.e13594] [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: 11/20/2022] Open
Abstract
e13594 Background: Given the expanding use of oral chemotherapies, optimal compliance to treatment is critical to achieve the best clinical outcome in terms of efficacy and safety. The aim of the OCTO clinical study was to measure patient compliance, either electronically or by self-assessment, to capecitabine-based treatment. Methods: A cohort of patients with either locally advanced or metastatic, breast or colorectal, cancer were monitored for 6 cycles, and ambulatory treated with monotherapy of capecitabine (Xeloda). Treatment was prescribed at 1250 mg/m² as a combination of 500 and 150 mg pills, taken twice daily for 14 days every 3-week cycle. Tumor response was evaluated after 3 and 6 cycles using the RECIST criteria. Toxicity was evaluated using the NCI CTC scale. Compliance was assessed in all patients by self-completed questionnaires on disease, treatment and ambulatory management of side effects; and in half of the cohort by electronic medication event monitoring systems (MEMS) recording the opening times of the pill bottle. Results: Forty patients were enrolled between November 2008 and September 2011 and treated by capecitabine for an average of 4.75 cycles (range: 1-6). 63% patients completed 6 cycles, 22% and 15% patients discontinued due to respectively disease progression and adverse events. Best tumor response was evaluable in 35 patients: 23% had partial response, 54% stable disease and 23% progressed. Hand-foot syndrome was the most reported toxicity (77% patients), and to a lesser extent diarrhea (45%), nausea (30%) and vomiting (30%). In the MEMS cohort, 20 patients were included. Patient compliance was excellent with very few missing occasions (23/2272 records). Timing of morning doses was less variable (p=0.03) than timing of evening ones. Thirty-eight questionnaires were returned. Autonomy of ambulatory oral treatment was appreciated by 54% patients, while resulting in anxiety in 6%. Only 39% patients were concerned by the potential impact of non-compliance while 45% declined answering the question. Conclusions: Compliance to oral anticancer chemotherapy was found excellent in this population, with few deviations from prescription.
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Affiliation(s)
| | - Aurelie Bourmaud
- Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France
| | - Olivier Colomban
- EMR 3738, Ciblage Thérapeutique en Oncologie, Faculté de Médecine et de Maïeutique Lyon-Sud Charles Mérieux, Université Claude Bernard Lyon1, Oullins, France
| | | | - Veronique Regnier
- Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France
| | - Benoit You
- EMR UCBL/HCL 3738, Faculté de Médecine Lyon-Sud, Université Claude Bernard Lyon 1; Hospices Civils de Lyon, Lyon, France
| | | | - Jerome Guitton
- Pharmacokinetic Department; Hospices Civils de Lyon; Centre Hospitalier Lyon-Sud; Lyon; France, Pierre-Benite, France
| | | | | | - Franck Chauvin
- Institut de Cancérologie de la Loire, Saint-Priest-En-Jarez, France
| | | | - Michel Tod
- Université Lyon 1 - EMR3738, Oullins, France
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Derombise G, van Schoors LV, Bourmaud A, Davies P. Morphological and physical evolutions of aramid fibers aged in a moderately alkaline environment. J Appl Polym Sci 2011. [DOI: 10.1002/app.34923] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Elloumi A, Pimbert S, Bourmaud A, Bradai C. Thermomechanical properties of virgin and recycled polypropylene impact copolymer/CaCO3 nanocomposites. POLYM ENG SCI 2010. [DOI: 10.1002/pen.21716] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Zribi K, Elleuch K, Feller J, Bourmaud A, Elleuch B. Eco-plastics: Morphological and mechanical properties of recycled poly(carbonate)-crushed rubber (rPC-CR) blends. POLYM ENG SCI 2007. [DOI: 10.1002/pen.20870] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Bourmaud A, Grohens Y, Zribi K, Feller JF. Investigation of the polycarbonate/crushed-rubber-particle interphase by nanoindentation. J Appl Polym Sci 2006. [DOI: 10.1002/app.25426] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Zribi K, Feller JF, Elleuch K, Bourmaud A, Elleuch B. Conductive polymer composites obtained from recycled poly(carbonate) and rubber blends for heating and sensing applications. POLYM ADVAN TECHNOL 2006. [DOI: 10.1002/pat.776] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Feller JF, Roth S, Bourmaud A. Conductive polymer composites: Electrical, thermal, and rheological study of injected isotactic poly(propylene)/long stainless-steel fibers for electromagnetic interferences shielding. J Appl Polym Sci 2006. [DOI: 10.1002/app.23141] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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