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Quality of teleconsultation in comparison to face-to-face consultation for pre anesthetic evaluation in pregnant persons before delivery will be evaluated. Quality is evaluated with a composite criterion comprising 7 elements required for security of anesthesia. Discordance between this composite criterion during the pre anesthesia visit the day of delivery and pre anesthesia consultation several weeks before delivery will be assessed.
In the third trimester of pregnancy, pre-anesthetic consultations are mandatory before childbirth, typically recommended between 32 and 36 weeks of gestation. These consultations assess risks associated with anesthesia and childbirth while providing information on anesthetic options, including neuraxial anesthesia. Since 2009, consultations can be conducted on-site or via teleconsultation. However, the quality of teleconsultations and patient satisfaction have not been evaluated in an obstetric context.
This study consists of two patient groups assigned following randomization:
Following patient enrollment, the follow-up protocol proceeds as outlined below:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Teleconsultation | Experimental | Patients randomized in teleconsultation arm. |
|
| In-person consultation | Active Comparator | Patients randomized in on-site consultation arm |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Teleconsultation | Procedure | pre-anesthetic consultation conducted conducted at the Bordeaux University Hospital by an obstetric anesthesia physician using the teleconsultation software provided by the hospital. |
| Measure | Description | Time Frame |
|---|---|---|
| Composite quality criterion | The primary endpoint will be the discordance between the pre-anesthetic consultation and the pre-anesthetic visit based on a composite quality criterion comprising 7 elements:
This primary criterion will be assessed at the conclusion of the pre-anesthetic visit. | during pre-anesthetic visit, up to 2 months after inclusion (pre-anesthetic consultation) |
| Measure | Description | Time Frame |
|---|---|---|
| Patient satisfaction | This questionnaire will include an overall assessment based on the question: "To what extent are you satisfied with your appointment with the anesthesiologist?", rated on a 5-point Likert scale (Very satisfied / Somewhat satisfied / Neither satisfied nor dissatisfied / Somewhat dissatisfied / Very dissatisfied) The remainder of the questionnaire will be developed for this study based on the validated CARE questionnaire. The CARE questionnaire is a tool developed by Stewart W. Mercer, initially for general practice, and validated in 2004. It focuses on the empathy patients perceive during consultations. It consists of 10 questions, rated on Likert scales. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Marion GRITON, MD | Contact | 05 57 82 17 22 | +33 | marion.griton@chu-bordeaux.fr |
| Hela KLAY | Contact | 05 40 45 12 34 | +33 | hela.klay@chu-bordeaux.fr |
| Name | Affiliation | Role |
|---|---|---|
| Marion GRITON | University Hospital, Bordeaux | Principal Investigator |
| Karine NOUETTE-GAULAIN | University Hospital, Bordeaux | Study Director |
| Florence SAILLOUR |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU de Bordeaux | Bordeaux | France |
|
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| ID | Term |
|---|---|
| D010549 | Personal Satisfaction |
| ID | Term |
|---|---|
| D001519 | Behavior |
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| ID | Term |
|---|---|
| D019114 | Remote Consultation |
| ID | Term |
|---|---|
| D012017 | Referral and Consultation |
| D011364 | Professional Practice |
| D009934 | Organization and Administration |
| D006298 | Health Services Administration |
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| on-site consultation | Procedure | In-person consultation conducted at the Bordeaux University Hospital according to the usual procedure. |
|
| 2 weeks after inclusion (pre-anesthetic consultation) |
| Anesthesiologist satisfaction | The experience of telemedicine consultations by anesthesiologists will be evaluated at the end of each half-day of consultations. Anesthesiologists and intensivists will be asked to complete a questionnaire consisting of 6 questions: Each response will be rated on a 5-point Likert scale, ranging from "strongly disagree" to "strongly agree" | at inclusion (pre anesthetic consultation) |
| missed appointment | A missed appointment is defined as the failure to conduct a pre-anesthetic consultations on the scheduled day due to the patient's absence or tardiness at the time of the appointment. Data on missed appointments will be collected for each patient included in the study. The rate of missed or rescheduled appointments will be calculated for each group. | at inclusion (pre anesthetic consultation) |
| Epidural anesthesia difficult to perform | The number of epidural anesthesias that are difficult to administer will be recorded. The criteria used to define a difficult administration are: more than three attempts at puncture or the involvement of a second practitioner. | up to 2 month after inclusion |
| Carbon footprint | The study will assess the carbon footprint of pre-anesthesia teleconsultations compared to in-person consultations by estimating greenhouse gas emissions associated with transportation. The carbon footprint of teleconsultations will be calculated using the emissions factor per minute of viewing time for teleconsultations, which depends on the energy consumption of the internet network and the carbon footprint of the internet infrastructure. | at inclusion (pre anesthetic consultation) |
| University Hospital, Bordeaux |
| Study Chair |
| D017216 | Telemedicine |
| D003695 | Delivery of Health Care |
| D010346 | Patient Care Management |