Wound Interdisciplinary Teams (WIT): A Community- Based Pragmatic Randomized Controlled Trial

NCT01348841 | Completed

• 1 other identifier: 25973
• Study Type: interventional
• Target: 451
• Locations: 1 country
• Sites: 1

Brief Summary

Wounds that are slow to heal (chronic) may be managed in different ways. In Ontario, care in the community for most of these is coordinated by the local Community Care Access Centre (CCAC). One or more health professionals might deliver treatment, individually or as part of a wound care team, with different members having different kinds of training (interdisciplinary team), which may or may not include wound care. Community treatment by interdisciplinary teams has been shown to be more effective and cost-effective for some long-standing health problems, but further scientific evidence is needed to determine if this is also true for chronic wounds. This study compares the usual way chronic wounds are being managed in the community with a so-called "intermediate care" approach. In this study, intermediate care will involve health service providers following certain agreed-upon steps (evidence-based best practice) from first contact with the client through assessment, treatment, and on to referral to a hospital specialty wound care team, if needed.

Conditions

Wound of Skin

Keywords

community wound care; systematic wound team referral; Advanced in-home nurse wound training

Outcome Measures

Primary Outcomes (1)

• Time to Healing

  The primary clinical outcome measure will be time to healing, ascertained by digital wound photography using computer planimetry for wound measurement.

  6 months

Secondary Outcomes (6)

• proportion of wound healed

  6 months

• Wound recurrence

  6 months

• time to discontinuation of wound service

  1 years

• Health Related Quality of Life (HRQOL)

  6 months

• client satisfaction

  6 months

Study Arms (2)

Control Arm

NO INTERVENTION

Usual care is care as currently delivered to clients with chronic wounds in the community.

Intervention Arm

EXPERIMENTAL

Systematic referral to MDWCT and comprehensive primary care: Intervention consists of systematic referral to MDWCT in conjunction with comprehensive primary care.Systematic referral to, and follow up, by MDWCTs, co-ordinated by the CM, will occur.There will be immediate referral to the MDWCT of clients with :1/ diabetic lower extremity ulcers,2/peripheral neuropathy, charcot changes,3/wound present longer than 4 mths. ,4/ Ankle Brachial Index less than 0.6, non-diabetics, and not being seen by a vascular surgeon. Subsequent referral to MDWCT will occur if less than 30% healing by week 4.

Other: Systematic referral to MDWCT and comprehensive primary care

Interventions

Systematic referral to MDWCT and comprehensive primary care OTHER

Systematic referral to, and follow up, by Multi-Disciplinary Wound Care Teams (MDWCTs), co-ordinated by the Case Manager (CM), will occur.There will be immediate referral to the MDWCT of clients with :1/ diabetic lower extremity ulcers,2/peripheral neuropathy, charcot changes,3/wound present longer than 4 mths. ,4/ Ankle Brachial Index less than 0.6, non-diabetics, and not being seen by a vascular surgeon. Subsequent referral to MDWCT will occur if less than 30% healing by week 4.

Also known as: systematic expedited referral to MDWCTs

Intervention Arm

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adult (\>18 years of age) client with eligible wound type (not surgical, malignant or burns) referred to the Toronto Central CCAC for wound management.
• Client (or substitute decision maker) provides written, informed consent.
• Someone in client's home (or substitute decision maker) must be able to speak English.

You may not qualify if:

• Surgical wounds
• Burns
• Malignant wounds
• Clients who are designated palliative on CCAC referral form

Sponsors & Collaborators

• University of Toronto: lead
• Ontario Ministry of Health and Long Term Care: collaborator

Study Sites (1)

THETA Collaborative

Toronto, Ontario, M5S 3M2, Canada

Location

Related Publications (10)

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  PMID: 17419961 BACKGROUND

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  PMID: 10791452 BACKGROUND

Study Officials

• Murray Krahn, PhD, MD

  Director

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Director, THETA

Study Record Dates

• First Submitted: May 4, 2011
• First Posted: May 5, 2011
• Study Start: May 1, 2011
• Primary Completion: June 1, 2013
• Study Completion: October 1, 2013
• Last Updated: October 25, 2013

Record last verified: 2013-10

Locations

CA (1)