Firminy

This trial investigates the best antithrombotic treatment for patients with acute venous thromboembolism VTE who are also taking antiplatelet therapy due to a history of stable atherosclerotic cardiovascular disease. VTE and atherosclerotic cardiovascular disease share common risk factors and often occur together, requiring the use of anticoagulant and antiplatelet drugs. The study aims to compare the benefits and risks of two treatment strategies to address concerns about bleeding and cardiovascular events in these patients. Participants will be randomly assigned to one of two groups. The experimental group will receive full-dose anticoagulant therapy alone, stopping antiplatelet therapy. The control group will continue combined full-dose anticoagulant and antiplatelet therapies, including aspirin or clopidogrel. Anticoagulant treatment will be given according to international guidelines for deep vein thrombosis DVT or pulmonary embolism PE, and treatment duration will be up to 12 months. During the study, participants will be monitored for clinically relevant bleeding, recurrent VTE, and major adverse ischemic cardiovascular and cerebrovascular events MACCE. Researchers will evaluate safety and effectiveness across these outcomes at the end of the treatment period. Secondary measures include non-major bleeding, arterial events, and VTE complications. The study involves regular assessments over up to one year to determine which treatment strategy offers the best overall clinical benefit.

Researchers are studying the impact of the Humanistic Partnership Health Care Model MPHS integrated into advanced practice nursing care for adults living with one or more stable chronic diseases. This program aims to strengthen the partnership between patients and nurses in primary care, helping patients play an active role in managing their chronic conditions. The study focuses on how this model supports patients self-management capacity, health literacy, quality of life, and care experience. The study compares two groups one receiving usual care from an advanced practice nurse and the other participating in the IMPACT program, which integrates the MPHS model. The IMPACT program involves three management phases co-defining the health situation, co-planning care and actions, and co-assessing progress with the patient and care team. Validated measurement tools are used within the program to address patient adaptation to chronic illness. Participants will engage in assessments over nine months, including measures of the patient-nurse partnership, health-related quality of life, health literacy, and consultation quality from the patients perspective. Adoption, participation, satisfaction, and effectiveness of the IMPACT program will be tracked over three years. The study uses random assignment to groups and single masking. Participation includes regular evaluations and collaboration with advanced practice nurses to support chronic disease management.

This trial focuses on people who have had surgery to repair a torn anterior cruciate ligament ACL, a common knee injury often caused by sports. Researchers are studying whether a personalized and optimized rehabilitation program guided by monthly assessments from physiotherapists during the 3 to 6 months after surgery can reduce the risk of new ACL injuries compared to standard rehabilitation. This phase is critical because the return to running and gradual resumption of sports vary greatly between patients, and there is no current consensus on objective criteria for this stage of recovery. The study compares two rehabilitation approaches. One group receives the usual rehabilitation following French national guidelines, with an evaluation at 6 months to decide if return to sport is allowed. The other group gets the usual rehabilitation plus expert physiotherapists perform monthly clinical and functional assessments from 3 to 6 months, providing personalized exercise and running recommendations to the treating physiotherapist. This optimized rehabilitation aims to better prepare patients for returning to their favorite sports activities. Participants will be monitored up to 24 months after surgery. Researchers will assess the number of patients who experience at least one new ACL injury, check who meets the criteria to return to sports at 6 months, record any post-surgical complications, and measure running biomechanical symmetry. These evaluations include clinical tests and functional assessments to track progress and safety. The study runs until December 2029 and involves young adults aged 18 to 25 who play competitive pivoting or contact sports.