Interest of Telemedicine in Primary Care in an Multidisability Population Institutionalized

Condition(s) studied

Investigational drug(s) / intervention(s)

Experimental procedure: swallowing assessment by telemedicine: The teleconsultation will be scheduled by the UVD programming IDE after contact by the structure team. This teleconsultation will take place in the presence of the patient's care assistant as well as medical staff (IDE, occupational therapist, physiotherapist, speech therapist, etc.) from the institution and a doctor specializing in swallowing and a speech therapist for the university hospital. The resident will do a food test under the eyes of CHU specialists. The patient will be able to test several textures (more or less solid/liquid) prepared in the center in order to be more accurate in their daily life. The meal will be in his familiar environment with his usual caregivers and tools. The CHU team will be able to interact directly with the institution's staff in order to have all the information necessary to determine their conclusions : questions, details on the patient's degree of compliance, etc.

Standard procedure: day hospitalization: Treatment for swallowing disorders in the hospital sector consists of the patient coming to the university hospital or to a day hospital in order to carry out a swallowing assessment consisting of invasive examinations such as nasofibroscopy (NF), swallowing fluoroscopy (VFS) as well as eating a meal outside the patient's usual context, sometimes in the presence of other people foreign to the patient (source of distractibility and sometimes anxiety).

Study summary

Swallowing disorders are common and fall within the scope of primary care (as basic, essential health services accessible to all individuals within a community). These swallowing disorders, strongly linked to the environment, do not require, in the majority of cases, a technical and intrusive evaluation. The main objective of this project is to study the relevance of an assessment of dysphagia by teleconsultation

Eligibility

Primary outcome measure(s)

• Recommendations on food textures — 1 month
  Recommendations regarding food textures will be assessed using the IDDSI (International Dysphagia Diet Standardization Initiative) scale during the V1 telemedicine visit and the V2 outpatient visit 15 days later. This scale consists of 8 categories ranging from 0 ("liquid texture") to 7 ("normal texture"), which are used to assess patients' swallowing abilities. This scale will be used to assess the recommended solid-textured diet (IDDSI 3 to 7) and liquid-textured diet (IDDSI 0 to 4). The relevance between the results of the telemedicine and the outpatient visit will be assessed.

Trial sites (5)

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