Addressing challenges in low-income and middle-income countries through novel radiotherapy research opportunities.

Although radiotherapy continues to evolve as a mainstay of the oncological armamentarium, research and innovation in radiotherapy in low-income and middle-income countries (LMICs) faces challenges. This third Series paper examines the current state of LMIC radiotherapy research and provides new data from a 2022 survey undertaken by the International Atomic Energy Agency and new data on funding. In the context of LMIC-related challenges and impediments, we explore several developments and advances-such as deep phenotyping, real-time targeting, and artificial intelligence-to flag specific opportunities with applicability and relevance for resource-constrained settings. Given the pressing nature of cancer in LMICs, we also highlight some best practices and address the broader need to develop the research workforce of the future. This Series paper thereby serves as a resource for radiation professionals.

Decreasing hospitalizations through geriatric hotlines: a prospective French multicenter study of people aged 75 and above.

BACKGROUND: The Emergency unit of the hospital (Department) (ED) is the fastest and most common way for most French general practitioners (GPs) to respond to the complexity of managing older adults patients with multiple chronic diseases. In 2013, French regional health authorities proposed to set up telephone hotlines to promote interactions between GP clinics and hospitals. The main objective of our study was to analyze whether the hotlines and solutions proposed by the responding geriatrician reduced the number of hospital admissions, and more specifically the number of emergency room admissions. METHODS: We conducted a multicenter observational study from April 2018 to April 2020 at seven French investigative sites. A questionnaire was completed by all hotline physicians after each call. RESULTS: The study population consisted of 4,137 individuals who met the inclusion and exclusion criteria. Of the 4,137 phone calls received by the participants, 64.2% (n = 2 657) were requests for advice, and 35.8% (n = 1,480) were requests for emergency hospitalization. Of the 1,480 phone calls for emergency hospitalization, 285 calls resulted in hospital admission in the emergency room (19.3%), and 658 calls in the geriatric short stay (44.5%). Of the 2,657 calls for advice/consultation/delayed hospitalization, 9.7% were also duplicated by emergency hospital admission. CONCLUSION: This study revealed the value of hotlines in guiding the care of older adults. The results showed the potential effectiveness of hotlines in preventing unnecessary hospital admissions or in identifying cases requiring hospital admission in the emergency room. Hotlines can help improve the care pathway for older adults and pave the way for future progress. TRIAL REGISTRATION: Registered under Clinical Trial Number NCT03959475. This study was approved and peer-reviewed by the Ethics Committee for the Protection of Persons of Sud Est V of Grenoble University Hospital Center (registered under 18-CETA-01 No.ID RCB 2018-A00609-46).

[The geriatric hotline improves practice, survey of general practitioners in the Saint-Etienne area]. / La hot line gériatrique, enquête auprès des médecins généralistes du bassin stéphanois.

Faced with an aging French population, the demand for unscheduled care is growing. In order to avoid referring elderly patients to emergency departments, which are unsuitable for them, the Regional Health Agencies have created telephone hot lines dedicated to geriatrics. They are exclusively accessible to general practitioners in order to obtain advice or a place in a geriatric hospital. General practitioners are rarely asked about the value of this tool in their practice.

Social marketing interventions to promote physical activity among 60 years and older: a systematic review of the literature.

BACKGROUND: Falls are a significant source of morbidity in people aged 65 and over, affecting one in three people in this age group. The scientific evidence indicates that physical activity is the most effective method for preventing falls among seniors. Although public health professionals often use social marketing to design and plan successful interventions, its use to promote physical activity and prevent falls among older people remains low. This article aims to provide a new systematic literature review of social marketing interventions promoting physical activity and targeting people aged 60 and over. METHODS: Following CRD's guidance and PRISMA guidelines, we searched between January 2008 and July 2019 for relevant articles in five primary databases using predefined search and inclusion criteria. Two independent reviewers analysed the selected articles to identify evidence of the seven social marketing benchmark criteria, defined by experts in the field as the common elements that contribute to social marketing success. RESULTS: The final review included nine studies. Of the studies selected, three specifically targeted over 60-year-olds, whereas the others segmented the population into several age-based subcategories, including over 60-year-olds. Eight studies highlighted positive results for the participants with an increase in participation or an increase in physical activity level. None of the nine studies selected for this systematic review implemented the entire social marketing approach. CONCLUSION: Few published interventions use the seven social marketing criteria. Further research is required to encourage uptake and inclusion in successful social marketing interventions to increase program effectiveness in this target population.

Correction to: Social marketing interventions to promote physical activity among 60 years and older: a systematic review of the literature.

An amendment to this paper has been published and can be accessed via the original article.

Chestnut Wood Tannins in Broiler Diets: Pharmacokinetics, Serum Levels during Rearing, and Intestinal Absorption Pattern of Gallic Acid.

Studies on the bioavailability, serum levels, and absorption of hydrolyzable tannin compounds are lacking. In this study, we performed a pharmacokinetic trial, measured the serum levels of compounds in broilers that were reared with different feed added or not with tannins, and tested the digestibility of tannins throughout the intestinal tract. Only gallic acid and 4-O-methyl gallic acid were found in the serum. Moreover, gallic acid showed a 41.8% absolute oral bioavailability and a 72.3% relative bioavailability of gallic acid from chestnut extract compared to the standard. The rapid metabolization caused alternating serum levels during the day and night. These patterns were not affected by the feed type or the previous addition of tannins in the feed. The absorption and metabolization in the intestines occurred gradually throughout the intestinal tract. The latter was true for gallic acid as well as ellagic acid, which was not found in the serum. We can conclude that components from chestnut tannins are absorbed throughout all components of the intestinal tract and are eliminated quickly with little interaction from the feed and previous addition of tannins. Moreover, ellagic acid seems to be absorbed but would remain accumulated in the intestinal tissue or be metabolized by the microbiome.

HPLC-DAD optimization of quantification of vescalagin, gallic and ellagic acid in chestnut tannins.

The quantification of hydrolysable polyphenols such as gallic, ellagic acid and vescalagin by HPLC-DAD is classically run after methanol extraction as a reference solvent. Water extraction is usually discarded because of a lower obtention of total polyphenol content compared to methanol extraction. In our study, methanol was compared to water extraction in both the total polyphenol content method and the HPLC-DAD analysis. Total polyphenol content in water extraction was lower than in methanol extraction, but water extraction gave better results on HPLC-DAD. In conclusion, total polyphenol content cannot be used as reference to choose the solvent of extraction to quantify some polyphenols by HPLC-DAD because of the specific properties of each polyphenol. Indeed, recovery results obtained on hydrolysable polyphenols with water extraction were better and with a lower variability than following methanol extraction.

Proximity to Radiotherapy Center, Population, Average Income, and Health Insurance Status as Predictors of Cancer Mortality at the County Level in the United States.

PURPOSE: Sufficient radiotherapy (RT) capacity is essential to delivery of high-quality cancer care. However, despite sufficient capacity, universal access is not always possible in high-income countries because of factors beyond the commonly used parameter of machines per million people. This study assesses the barriers to RT in a high-income country and how these affect cancer mortality. METHODS: This cross-sectional study used US county-level data obtained from Center for Disease Control and Prevention and the International Atomic Energy Agency Directory of Radiotherapy Centres. RT facilities in the United States were mapped using Geographic Information Systems software. Univariate analysis was used to identify whether distance to a RT center or various socioeconomic factors were predictive of all-cancer mortality-to-incidence ratio (MIR). Significant variables (P ≤ .05) on univariate analysis were included in a step-wise backward elimination method of multiple regression analysis. RESULTS: Thirty-one percent of US counties have at least one RT facility and 8.3% have five or more. The median linear distance from a county's centroid to the nearest RT center was 36 km, and the median county all-cancer MIR was 0.37. The amount of RT centers, linear accelerators, and brachytherapy units per 1 million people were associated with all-cancer MIR (P < .05). Greater distance to RT facilities, lower county population, lower average income per county, and higher proportion of patients without health insurance were associated with increased all-cancer MIR (R-squared, 0.2113; F, 94.22; P < .001). CONCLUSION: This analysis used unique high-quality data sets to identify significant barriers to RT access that correspond to higher cancer mortality at the county level. Geographic access, personal income, and insurance status all contribute to these concerning disparities. Efforts to address these barriers are needed.

Prospective multicentered study describing the health pathway of a short-stay geriatric population hospitalised through geriatric telephonic hotline / Étude prospective multicentrique décrivant le parcours de soins d'une population gériatrique hospitalisée en court séjour via une hotline gériatrique

Rationale: The ARS finance geriatric hotlines in order to improve the articulation between town medicine and the hospital. The objective of our study is to describe the health status and the care pathway of subjects aged over 75 years hospitalised in a geriatric short stay hospital via a geriatric hotline. Materials and methods: This prospective multicentre study included 1,451 subjects over 24 months. The primary endpoint was the average length of stay. The secondary endpoints were medico-socio-demographic data. Results: The population hospitalised via a hotline is comparable to that usually found in geriatric short stay services. The length of stay is correlated with the lifestyle and the mode of discharge (p < 0.001). There was a significant excess risk of non-return to the previous place of residence according to age, average length of stay, comorbidities and degree of dependence. Conclusion: The care pathway for elderly people over 75 years old hospitalised through the hotline is optimised, with an average length of stay of 14 days, demonstrating a good link between town medicine and hospital. This approach allows for the early management of elderly subjects in the geriatric care system.

Rationnel: Les Agences régionales de santé (ARS) financent des hotlines gériatriques en vue d'améliorer l'articulation entre la médecine de ville et l'hôpital. L'objectif de notre étude est de décrire l'état de santé et le parcours de soin des sujets âgés de plus de 75 ans hospitalisés en court séjour gériatrique via une hotline gériatrique. Matériel et méthode: Cette étude multicentrique prospective a inclus 1 451 sujets sur 24 mois. Le critère de jugement principal est la durée moyenne de séjour (DMS). Les critères de jugements secondaires sont les données médico-socio-démographiques. Résultats: La population hospitalisée via une hotline est comparable à celle habituellement retrouvée dans les services de court séjour gériatrique. La DMS est corrélée au mode de vie et au mode de sortie (p < 0,001). Il existe un surrisque significatif de non-retour au lieu de vie antérieur selon l'âge, la durée moyenne de séjour, les comorbidités et le degré de dépendance. Conclusion: Le parcours de soins du sujet âgé de plus de 75 ans passant par la hotline est optimisé avec une durée moyenne de séjour à 14 jours, témoignant d'une bonne articulation entre médecine de ville et hôpital. Cette démarche permet de prendre en charge précocement les sujets âgés dans la filière gériatrique.

Chestnut tannins in broiler diets: Affecting intestinal development in different feeding phases.

It is known that high doses of various tannins could impair broiler growth, and this seems to be linked to a lowered protein availability. However, effects on protein digestion under the influence of hydrolysable tannins were minimal in previous research and literature. Other possible proposed reasons to explain reduced growth are scarce. In this experiment we studied the effect of hydrolysable tannins on body allometry by using different feeding schemes throughout the rearing period. In total 112 individually reared male Ross 308 broilers received a 3-phase basal diet with chestnut wood extract (+: 2,000 mg/kg) or not (-: 0 mg/kg) (Tanno-SAN®, Sanluc International NV, Belgium). This resulted in 2 groups during the starter period (S+, S-), 4 groups in the grower period (G++, G+-, G-+, G-) and 8 groups in the finisher period (F+++, F++-, F+-+, F+--, F-++, F-+-, F--+, F--). Similar to previous studies, growth reduction was also observed in this study. Effects were the largest in broilers that were given the tannins during the grower phase. At the end of each phase 8 broilers per group were euthanized and sampled. Liver, pancreas, pectoralis muscle, intestinal weights and intestinal length were recorded. The largest effects were seen on the intestine. Broilers that received tannins during the grower phase, had longer intestines at the end of the finisher period. Furthermore, histological differences between treatment groups were observed at the end of the grower period. Addition of tannins in the grower phase (G-+, G++) resulted in longer villi, whereas addition of tannins in the starter (G+-, G++) caused deeper crypts at the end of the grower phase, with the group (G-+) having the highest villi-to-crypt ratio. These results tentatively prove that tannins influence intestinal growth, both macroscopically as well as histologically. We hypothesize that the observed growth reduction with tannins could be the result of a changed energy and nutrient partitioning, i.e., more nutrients are directed to intestinal growth than for muscle growth.

Chestnut tannins in broiler diets: performance, nutrient digestibility, and meat quality.

In 2 broiler trials, the effects of chestnut tannins on performance and meat quality (trial 1), and digestion (trial 2) were evaluated. In both trials, Ross 308 broilers received one of 2 basal diets: one basal diet contained corn and soy as main feed ingredients, while the challenge basal diet contained wheat, palm oil, and rapeseed meal. The composition of the basal diets was chosen to assess the interaction between chestnut tannins and diet composition. To both basal diets, chestnut tannins were added at 3 doses: 0 mg/kg (T-), 500 mg/kg (T+), or 2,000 mg/kg (T++), resulting in a total of 6 treatments. In trial 1, both basal diets containing 2,000 mg/kg chestnut tannins lowered broiler performance in grower and finisher phases. A tannin dose of 500 mg/kg had no effect on performance in either basal diet. Corn-based diets resulted in lower meat pH compared to wheat diets. Further, addition of chestnut tannins resulted in increased meat pH, and caused proportionally a lower meat drip loss and shear force for both basal diets. During the digestibility study (trial 2), blood was also collected. None of the treatments affected digestibility or blood parameters (glucose, non-esterified fatty acids, and triacylglycerols). Malondialdehyde (MDA) was measured in plasma to assess antioxidative properties of chestnut tannins. In wheat diets, chestnut tannins significantly lowered plasma MDA demonstrating its antioxidative nature. Regarding gut health, crypt depth decreased proportionally with the dosage of chestnut tannins in both basal diets with significantly shallower crypts for the wheat diets compared to the corn diets. Relative intestinal growth was stimulated in the wheat diets proportionally to the tannin dose based on the larger relative gut length. In conclusion, chestnut tannins did not influence digestive metabolism, yet they lowered performance at higher doses regardless of feed ingredients used in the diet. Tannins positively affected meat quality and when added to wheat diets, intestinal growth was stimulated and the antioxidative status of the broilers improved.

Social Marketing Intervention to Engage Older Adults in Balance Workshops for Fall Prevention: A Multicenter Quasi-Experimental Protocol Study.

Background: Falls affects one of three people after 65 years old, and it can lead to serious consequences. Scientific evidence point out that physical exercise is the most efficient way to prevent falls among older adults. Objective: The main objective of this study is to determine if a social marketing program can increase the attendance rate of people aged 60 and over at group balance workshops. Methods: This quasi-experimental multicenter study is being conducted in three French Regions (Loire, Haute-Loire and Rhône) over a period of 18 months. The Social Marketing Campaign will be done in three ways. Firstly, a Communication Campaign will take place in the two Test Areas but not in the Control Area. Secondly, flyers have been designed to be distributed by local partners. Finally, conferences for older people will be organized in the areas of intervention in order to reach the target audience for the program. The study will include people aged 60 and older who want to participate in the Balance Program. Results: The Crédit Agricole Loire/Haute-Loire Foundation funded the study and the Jean Monnet University of Saint-Etienne reviewed it. The Ethics Committee of the University Teaching Hospital of Saint-Etienne approved and peer-reviewed it on September 6, 2019, under Reference Number IRBN622019/CHUSTE. Conclusion: The results of this first study will demonstrate whether or not social marketing for promoting group balance workshops in the elderly will increase their attendanceship in adapted physical activity sessions, especially those that prevent falls. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT04136938, identifier NCT04136938.

COVID-19 and Quarantine, a Catalyst for Ageism.

In February 2021, France had more than 76,000 deaths due to COVID-19 and older adults were heavily affected. Most measures taken to reduce the impact of COVID-19 (quarantine, visit ban in nursing home, etc.) significantly influenced the lives of older adults. Yet they were rarely consulted about their implementation. Exclusion of and discrimination against older adults has been accentuated during the COVID-19 pandemic. While many articles discussing COVID-19 also mention ageism, few actually incorporate the perspectives and opinions of older adults. Our research aims to assess the ageism experienced by older adults during the COVID-19 pandemic. We conducted interviews with older adults (63-92 years, mean age = 76 years) in an urban area of France. Participants reported experiencing more ageism during the COVID-19 pandemic, including hostile and benevolent ageism from older adults' families. Despite reports of experiencing ageist attitudes and behaviors from others, however, older adults also identified positive signs of intergenerational solidarity during this COVID-19 crisis.

Impact of Home Quarantine on Physical Activity Among Older Adults Living at Home During the COVID-19 Pandemic: Qualitative Interview Study.

BACKGROUND: Older adults and those with pre-existing medical conditions are at risk of death from severe acute respiratory syndrome coronavirus 2 (SARS CoV-2). In this period of quarantine, one of the reasons for going out is physical activity. This issue is important, as the impact of a sedentary lifestyle might be lower for children and young adults, but is far more severe for older adults. Although older adults need to stay at home because they have a higher risk of coronavirus disease (COVID-19), they need to avoid a sedentary lifestyle. Physical activity is important for older adults, especially to maintain their level of independence, mental health, and well-being. Maintaining mobility in old age is necessary, as it may predict loss of independence in older adults. OBJECTIVE: Our first objective was to evaluate the impact of this quarantine period on physical activity programs and on the physical and mental health of older adults. Our second objective was to discuss alternatives to physical activity programs that could be suggested for this population to avoid a sedentary lifestyle. METHODS: We conducted a qualitative survey using semistructured interviews with professionals (managers in charge of physical activity programs for older adults and sports trainers who run these physical activity programs) from the French Federation of Physical Education and Voluntary Gymnastics (FFPEVG) and older adults participating in a physical activity program of the FFPEVG. We followed a common interview guide. For analysis, we carried out a thematic analysis of the interviews. RESULTS: This study suggests that the COVID-19 epidemic has affected, before quarantine measures, the number of seniors attending group physical activity programs in the two study territories. In addition, despite the decline in their participation in group physical activities before the quarantine, older adults expressed the need to perform physical activity at home. There is a need to help older adults integrate simple and safe ways to stay physically active in a limited space. A national policy to support older adults for physical activity at home appears essential in this context. CONCLUSIONS: Given the results of our study, it seems necessary to globally communicate how important it is for older adults to maintain physical activity at home. We are concerned about the level of independence and mental health state of older adults after the end of quarantine if there is no appropriate campaign to promote physical activity among them at home.

Recurrence or Relapse of COVID-19 in Older Patients: A Description of Three Cases.

BACKGROUND: COVID-19 has infected millions of people worldwide, particularly in older adults. The first cases of possible reinfection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were reported in April 2020 among older adults. DESIGN/SETTING: In this brief report, we present three geriatric cases with two episodes of SARS-CoV-2 infection separated by a symptom-free interval. PARTICIPANTS: The participants of this brief report are three cases of hospitalized geriatric women. MEASUREMENTS/RESULTS: We note clinical and biological worsening during the second episode of COVID-19 for all three patients. Also, there is a radiological aggravation. The second episode of COVID-19 was fatal in all three cases. CONCLUSION: This series of three geriatric cases with COVID-19 diagnosed two times apart for several weeks questions the possibility of reinfection with SARS-CoV-2. It raises questions in clinical practice about the value of testing for SARS-CoV-2 infection again in the event of symptomatic reoccurrence. J Am Geriatr Soc 68:2179-2183, 2020.

Domestic Activities Associated With a Decreased Risk of Cognitive Disorders: Results of the "Fréle" Cohort.

Background: Previous cohorts studied the association of various types of physical activities with the incidence of cognitive disorders. The objective of this work was to analyze the association of leisure, domestic and professional physical activities with mild and moderate cognitive disorders in older people living in the community. Methods: We used retrospective data from the "FRéLE" (FRagilité: étude Longitudinale de ses Expressions) a longitudinal and observational study. Data collected included socio-demographic variables, lifestyle and health status. Cognitive disorders were assessed using the Montreal Cognitive Assessment (MoCA). Two cut-offs of MoCA were used to analyze mild and moderate cognitive disorders. Physical activity was assessed by the Physical Activity Scale for the Elderly (PASE) structured in three sections: leisure, household, and professional activities. Spline and logistic regression models were used to estimate the risk of cognitive disorders. Results: At baseline, 428 participants (for study of mild disorders) and 1,271 participants (for study of moderate disorders) without cognitive disorders were included in the analysis. The mean ages were 74 and 78 years, respectively. After a 2-year follow-up, we found mild cognitive disorders in 154 participants (36%) and 71 cases of moderate cognitive disorders (5.6%). In multi-adjusted logistic models, domestic activities were associated with cognitive disorders, but not leisure and professional activities. Conclusion: We found an inverse relation between domestic sub-score and cognitive disorders defined by MoCA < 18. With a specific questionnaire and quantitative information on the type of activities, this study contributed to the debate on the beneficial effects of physical activity on cognition.

Surveillance of Cardiovascular Risk Factors in the Fifth Military Sector Health Center, Ngaoundéré, Cameroon: Observational Study.

BACKGROUND: Noncommunicable diseases (NCDs) are the leading causes of death worldwide. They were responsible for 40 million of the 57 million deaths recorded worldwide in 2016. In Cameroon, epidemiological studies have been devoted to NCDs and their risk factors. However, none provides specific information on their extent or the distribution of their risk factors within the Cameroonian defense forces. OBJECTIVE: The objective of our study was to assess the cardiovascular risk of a Cameroonian military population compared with that of its neighboring civilian population. METHODS: We conducted a cross-sectional study that involved subjects aged 18 to 58 years, recruited from October 2017 to November 2018 at the Fifth Military Sector Health Center in Ngaoundéré, Cameroon. Data collection and assessment were done according to the World Health Organization (WHO)'s STEPS manual for surveillance of risk factors for chronic NCDs and the Alcohol Use Disorders Identification Test. Five cardiovascular risk factors were assessed: smoking, harmful alcohol consumption, obesity/overweight, hypertension, and diabetes. The risk was considered high in subjects with 3 or more of the factors. Univariate analysis and multivariate logistic regression were carried out according to their indications. RESULTS: Our study sample of 566 participants included 295 soldiers and 271 civilians of the same age group (median age 32 years versus 33 years, respectively; P=.57). The military sample consisted of 31 officers and 264 noncommissioned officers (NCOs). Soldiers were more exposed to behavioral risk factors than civilians, with a prevalence of smoking of 13.9% versus 4.4% (P<.001) and excessive alcohol consumption of 61.7% versus 14.8% (P<.001). They also presented with a higher cardiovascular risk than civilians (odds ratio 2.7, 95% CI 1.50-4.81; P<.001), and among the military participants, the cardiovascular risk was higher for officers than for NCOs (51.6% versus 14.0%, respectively; P<.001). CONCLUSIONS: Cameroonian soldiers are particularly exposed to cardiovascular behavioral risk factors and consequently are at higher risk of NCDs. TRIAL REGISTRATION: ClinicalTrials.gov NCT04315441; https://clinicaltrials.gov/ct2/show/NCT04315441.

Impact of Geriatric Hotlines on Health Care Pathways and Health Status in Patients Aged 75 Years and Older: Protocol for a French Multicenter Observational Study.

BACKGROUND: In France, emergency departments (EDs) are the fastest and most common means for general practitioners (GPs) to cope with the complex issues presented by elderly patients with multiple conditions. EDs are overburdened, and studies show that being treated in EDs can have a damaging effect on the health of elderly patients. Outpatient care or planned hospitalizations are possible solutions if appropriate geriatric medical advice is provided. In 2013, France's regional health authorities proposed creating direct telephone helplines, "geriatric hotlines," staffed by geriatric specialists to encourage interactions between GP clinics and hospitals. These hotlines are designed to improve health care pathways and the health status of the elderly. OBJECTIVE: This study aims to describe the health care pathways and health status of patients aged 75 years and older hospitalized in short-stay geriatric wards following referral from a geriatric hotline. METHODS: The study will be conducted over 24 months in seven French university hospital centers. It will include all patients aged 75 and older, living in their own homes or nursing homes, who are admitted to short-stay geriatric wards following hotline consultation. Two questionnaires will be filled out by medical staff at specific time points: (1) after conducting the telephone consultation and (2) on admitting the patient to a short-stay geriatric medical care. The primary endpoint will be mean hospitalization duration. The secondary endpoints will be intrahospital mortality rate, the characteristics of patients admitted via the hotline, and the types of questions asked and responses given via the hotline. RESULTS: The study was funded by the National School for Social Security Loire department (École Nationale Supérieure de Sécurité Sociale) and the Conference for funders of prevention of autonomy loss for the elderly of the Loire department in November 2017. Institutional review board approval was obtained in April 2018. Data collection started in May 2018; the planned end date for data collection is May 2020. Data analysis will take place in the summer of 2020, and the first results are expected to be published in late 2020. CONCLUSIONS: The results will reveal whether geriatric hotlines provide the most effective management of elderly patients, as indicated by shorter mean hospitalization durations. Shorter hospital durations could lead to a reduced risk of complications-geriatric syndromes-and the domino chain of geriatric conditions that follow. We will also describe different geriatric hotlines from different cities and compare how they function to improve the health care of the elderly and pave the way toward new advances, especially in the organization of the care path. TRIAL REGISTRATION: ClinicalTrials.gov NCT03959475; https://clinicaltrials.gov/ct2/show/NCT03959475. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/15423.