1. Time spent in hospital during the preceding six months (Time Frame - Once at baseline (before randomization of practices) and once at follow-up (immediately after the intervention)): The outcome will be assessed by asking the patients how often they had been in hospital during the preceding six months and how many days each hospital stay lasted. The total time in hospital will be calculated by adding the duration of all stays together.
Secondary outcome:
1. The number of contacts with the GP during the preceding six months (Time Frame - Once at baseline (before randomization of practices) and once at follow-up (immediately after the intervention)): The outcome will be assessed by asking the patients how often they had used their GP during the preceding six months.
2. The number of contacts with outpatient specialists during the preceding six months (Time Frame - Once at baseline (before randomization of practices) and once at follow-up (immediately after the intervention)): The outcome will be assessed by asking the patients how often they had used outpatient specialists during the preceding six months.
3. The number of contacts with home care services during the preceding six months (Time Frame - Once at baseline (before randomization of practices) and once at follow-up (immediately after the intervention)): The outcome will be assessed by asking the patients how often they had used home care services during the preceding six months.
4. Process quality of care as assessed by the summary score of the "GP-reported core set of quality indicators for older adults with multimorbidity in primary care" during the preceding six months (Time Frame - Once at baseline (before randomization of practices) and once at follow-up (immediately after the intervention)): The outcome will be assessed by the "GP-reported core set of quality indicators for older adults with multimorbidity in primary care" (Schäfer I et al. 2023, DOI: https://doi.org/10.1186/s12916-023-02856-0), which has a possible range between 0 and 12 points. Higher scores indicate a better quality of primary care.
5. Process quality of care as assessed by the summary score of the "patient-reported core set of quality indicators for older adults with multimorbidity in primary care" during the preceding six months (Time Frame - Once at baseline (before randomization of practices) and once at follow-up (immediately after the intervention)): The outcome will be assessed by the "Patient-reported core set of quality indicators for older adults with multimorbidity in primary care" (Schäfer I et al. 2023, DOI: https://doi.org/10.1186/s12916-023-02856-0), which has a possible range between 0 and 7 points. Higher scores indicate a better quality of primary care.
6. Self-rated health as assessed by the EuroQoL visual analogue scale (Time Frame - Once at baseline (before randomization of practices) and once at follow-up (immediately after the intervention)): The outcome will be assessed by the EuroQoL visual analogue scale (Herdman M et al. 2011, DOI: 10.1007/s11136-011-9903-x), which has a possible range between 0 and 100 points. Higher scores indicate a better self-rated health.
7. Health-related quality of life as assessed by the "EuroQoL five dimension five level scale" descriptive system, German value set (Time Frame - Once at baseline (before randomization of practices) and once at follow-up (immediately after the intervention)): The outcome will be assessed by the "EuroQoL five dimension five level scale" (EQ-5D-5L) descriptive system (Herdman M et al. 2011, DOI: 10.1007/s11136-011-9903-x). A summary score will be calculated using the German value set (Ludwig K et al. 2018, DOI: 10.1007/s40273-018-0615-8). According to the German value set, the EQ-5D descriptive system has a possible range between 1.0 and -0.661 points. Higher scores indicate a better health-related quality of life.
8. Patient satisfaction with organization of care as assessed by the European Task Force on Patient Evaluation of General Practice Care questionnaire (Time Frame - Once at baseline (before randomization of practices) and once at follow-up (immediately after the intervention)): The outcome will be assessed by subscale 'organization of care' of the European Task Force on Patient Evaluation of General Practice Care questionnaire (EUROPEP, Wensing M et al. 2000, DOI: https://doi.org/10.3109/13814780009069953). The score has a possible range between 0 and 4 points each and higher values indicate higher patient satisfaction.
9. Patient satisfaction with clinical performance as assessed by the European Task Force on Patient Evaluation of General Practice Care questionnaire (Time Frame - Once at baseline (before randomization of practices) and once at follow-up (immediately after the intervention)): The outcome will be assessed by subscale 'clinical performance' of the European Task Force on Patient Evaluation of General Practice Care questionnaire (EUROPEP, Wensing M et al. 2000, DOI: https://doi.org/10.3109/13814780009069953). The score has a possible range between 0 and 4 points each and higher values indicate higher patient satisfaction.
Experimental: Intervention group GPs in the intervention arm have to use the web application for every patient at least twice (i.e., at least once a quarter), and have to use at least four specific questionnaires at least once, i.e. 1a is required, and either 2a or 2b, and either 3a or 3b, and either 4a or 4b or 4c. Results from the questionnaires need to be discussed between GPs and patients. Additionally, at least one medication review is obligatory.
gp-multitool.de: The intervention is based on a digital tool, which implements recommendations of the S3 guideline "multimorbidity" of the German College of General Practitioners and Family Physicians. The tool includes nine questionnaires addressing four dimensions of care:
preferences (including a. treatment goals, and b. involvement of other persons in decision making);
activities (including a. activities and participation, and b. social support);
treatment (including a. problems with medication, and b. treatment burden);
complaints (including a. pain, b. psychiatric disorders, and c. other complaints).
The GPs can send the questionnaires by email to the patients and the patients can fill out the questionnaires at their home or in the waiting room of the GP's practice using their own smartphones, tablets or computers. The digital tool also includes instructions for conducting a medication review. Results from talks between GPs and patients can be documented in the tool.
Quelle: ClinicalTrials.gov
Sie können folgenden Inhalt einem Kollegen empfehlen:
"Digital Tool Enhancing GPs' Information Management for Patients With Multimorbidity - a Pilot Study"
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