Firminy

Venous thromboembolism (VTE) and atherosclerotic cardiovascular disease often occur together and share similar risk factors. Managing these conditions requires antithrombotic treatments, including anticoagulant therapy (AC) to prevent VTE recurrence and antiplatelet therapy (AP) to prevent major cardiovascular and cerebrovascular events. The combination of AC and AP can increase the risk of side effects, especially bleeding, which is a leading cause of emergency admissions related to adverse drug reactions. This Phase 3 trial compares two treatment strategies in patients with acute VTE who are also taking antiplatelet therapy for atherosclerotic cardiovascular disease. One group receives full-dose anticoagulant therapy alone, while the other group receives combined full-dose anticoagulant therapy plus antiplatelet therapy (aspirin or clopidogrel). The anticoagulant choice is at the investigator's discretion following international guidelines. The study aims to evaluate which strategy better balances the risk of bleeding and cardiovascular events. Participants are monitored for clinically relevant bleeding events during up to 12 months of full-dose treatment. The study also assesses recurrent venous thromboembolism and major adverse ischemic cardiovascular and cerebrovascular events. Throughout the study, researchers collect data on safety and effectiveness to determine the net clinical benefit of each treatment approach. Participation involves regular evaluations and follow-up over the treatment period.

The trial investigates how integrating the Humanistic Partnership Health Care Model (MPHS) into advanced practice nursing affects the partnership between patients with stabilized chronic diseases and their nurses. It focuses on supporting patients' ability to manage chronic conditions by considering their values, needs, and preferences. The study addresses key factors like self-management capacity, health literacy, quality of life, and care experience to improve chronic disease management in primary care. Participants receive care through the IMPACT program, which uses the MPHS model in three phases: co-defining the health situation, co-planning care and actions, and co-assessing progress with the patient and care team. This approach is compared to usual care provided by an advanced practice nurse. The program incorporates evidence-based measurement tools tailored to the patient's priorities and life goals while managing their chronic condition(s). Throughout the study, patients and nurses work closely to develop and evaluate a personalized care plan. Researchers measure the quality of the patient-nurse partnership at 9 months to understand the program's impact. Participation involves ongoing collaboration and use of validated tools to assess adaptation to chronic disease, with a focus on enhancing the patient's role in managing their health.

Researchers are studying people who have had surgery to rebuild their anterior cruciate ligament (ACL), a common knee injury often caused by sports. The study focuses on improving rehabilitation after the first three months post-surgery, which follows a standard protocol in France. The goal is to see if a personalized, optimized rehabilitation program guided by monthly physiotherapist assessments between the 3rd and 6th months after surgery can reduce the risk of new ACL injuries, compared to usual rehabilitation methods. Participants will be assigned to one of two groups: one receiving usual rehabilitation according to French health authority guidelines, and another receiving an optimized rehabilitation following the study protocol. The optimized program includes personalized rehabilitation and guided running training designed to better prepare patients for returning to their favorite sports. Rehabilitation focuses on phases including return to running and preparation for full return to training and competition. During the study, patients will undergo monthly assessments from 3 to 6 months after surgery to monitor progress. Researchers will evaluate the number of patients who experience a new ACL injury within 24 months after surgery. The study includes tests to assess functional abilities and readiness to return to sport. Safety and adherence to rehabilitation will be monitored throughout the study period to help improve long-term outcomes after ACL reconstruction.