Effectiveness of a Computerised Prompt for Primary and Secondary Care Physicians to Refer or Refer Back Type 2 Diabetes Patients
1 other identifier
interventional
2,779
1 country
2
Brief Summary
Patients with type 2 diabetes mellitus can receive care in the general practice or at the outpatient clinic. In the region of Amersfoort in The Netherlands, primary care practices and the hospital are connected through Diamuraal to organize the diabetes care in that region. They work in the same electronic medical record, and patients can request access to their own record (called a patient web portal). They set up Diamuraal guidelines, based on the guidelines of the Dutch College of General Practitioners and Internists, on where the patient care needs to be allocated (primary or secondary care), depending on the amount of specific care a patient needs. Despite guidelines, not all patients are treated in the correct place. Our hypotheses is that when we improve triage we can cause a major shift from treatment in secondary care to primary care and from primary care to self-care by using the patient web portal. Furthermore, patients who needs extra attention due to problems with their diabetes or complications can receive this extra attention due to increased e-consultation between primary care and secondary care and if necessary actually can, during a short time, be treated by an internist. We hope to achieve this by introducing a signal in the electronic medical record. This signal allocates patients according to the guidelines and warns a physician if their patients is not treated according to that guideline. The health care provider can then discuss this situation with his patient. We believe that this leads to shift in allocation of care, in which optimal care is provided and patients are made more aware of their situation which hopefully leads to better self-management and satisfaction.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable diabetes-mellitus
Started Oct 2013
2 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
Study Start
First participant enrolled
October 1, 2013
CompletedFirst Submitted
Initial submission to the registry
August 27, 2014
CompletedFirst Posted
Study publicly available on registry
August 29, 2014
CompletedPrimary Completion
Last participant's last visit for primary outcome
October 1, 2014
CompletedStudy Completion
Last participant's last visit for all outcomes
March 1, 2015
CompletedJune 16, 2015
June 1, 2015
1 year
August 27, 2014
June 15, 2015
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
The number of participants with change in allocation of care after intervention
One of the following: 1. shift from primary care to secondary care 2. shift from secondary care to primary care 3. continuation of treatment in primary care but with addition of e-consultation with secondary care 4. continuation of treatment in primary care but with replacement of one or more office visits in self-control
One year
Secondary Outcomes (4)
Assembly of reasons by health care providers for not following the guidelines
One year
Change in quality of diabetes care
One year
Change in diabetes treatment satisfaction
One year
Number of participants who meet their treatment goals
One year
Study Arms (2)
Signal
ACTIVE COMPARATORIn addition to usual care, there will be an automatic signal in the electronic medical record (EMR) upon opening that will show the reader that the patient is currently not treated in the correct treatment setting and it simultaneously will give advice to which treatment allocation this patient should be transferred to.
No signal
NO INTERVENTIONPatients receive usual care, consisting of 4 office visits yearly
Interventions
Eligibility Criteria
You may qualify if:
- patients with type 2 diabetes mellitus
- health care provider work within Diamuraal setting
You may not qualify if:
- \- none
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- UMC Utrechtlead
Study Sites (2)
Diamuraal-associated GP practices
Amersfoort, Netherlands
Meander Medical Center
Amersfoort, Netherlands
Related Publications (1)
Ronda MC, Dijkhorst-Oei LT, Gorter KJ, Beulens JW, Rutten GE. Differences between diabetes patients who are interested or not in the use of a patient Web portal. Diabetes Technol Ther. 2013 Jul;15(7):556-63. doi: 10.1089/dia.2013.0023. Epub 2013 Jun 18.
PMID: 23777369BACKGROUND
Related Links
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Study Officials
- PRINCIPAL INVESTIGATOR
Guy EH Rutten, MD PhD
UMC Utrecht
- STUDY DIRECTOR
Lioe-Ting Dijkhorst-Oei, MD, PhD
UMC Utrecht
- STUDY DIRECTOR
Maaike CM Ronda, MD
UMC Utrecht
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- NONE
- Purpose
- HEALTH SERVICES RESEARCH
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- Professor
Study Record Dates
First Submitted
August 27, 2014
First Posted
August 29, 2014
Study Start
October 1, 2013
Primary Completion
October 1, 2014
Study Completion
March 1, 2015
Last Updated
June 16, 2015
Record last verified: 2015-06