Testing the SNOWDROP Intervention: Using a Clinical Decision Support System and Patient Portal for Falls Prevention Among Older Patients in Primary Care

NCT05611008 | Completed

• 1 other identifier: 2022-PC-15274
• Study Type: interventional
• Target: 85
• Locations: 1 country
• Sites: 1

Brief Summary

Falls are a leading cause of injuries among older patients. Medication use is a major risk factor for falls. Because we lack tools to assess individualized risks, general practitioners (GPs) struggle with fall-related medication management for older patients. Furthermore, these older patients are often not properly equipped to engage in the joint management of their medication. A Clinical Decision Support System (CDSS) for GPs and a patient portal for older patients may stimulate shared decision making between GPs and older patients when discussing the medication-related fall risk. The CDSS provides the GP with advice on how to alter medication in such a way that the fall risk decreases, and the patient portal helps the older patient to prepare for a consultation and to engage in the joint management of their medication.

Conditions

Fall; Fall Injury; Fall Patients; Accidental Fall; Deprescribing

Outcome Measures

Primary Outcomes (1)

• Shared decision making

  This concerns the extent to which shared decision making between patient and GP during the consultation. This will be assessed using the Observer OPTION Multiple Chronic Conditions (OPTION-MCC). Consultation are audiotaped and will be coded on shared decision making using this coding scheme.

  During consultation

Secondary Outcomes (10)

• Technology Acceptance Model (TAM; patient portal)

  At baseline & two weeks after consultation

• Website Satisfaction Scale (WSS; patient portal)

  At baseline & two weeks after consultation

• Patient portal usage

  At baseline & two weeks after consultation

• Beliefs About Medicines Questionnaire (BMQ)

  Baseline & two weeks after consultation

• Netherlands Patient Information Recall Questionnaire (NPIRQ)

  Two weeks after consultation

Study Arms (2)

Intervention condition

EXPERIMENTAL

Device: CDSS; Device: Patient Portal

Control condition

NO INTERVENTION

Interventions

CDSS DEVICE

A Clinical Decision Support System (CDSS) that calculates older patients' personalized fall risk and provides the GP with advice on how to adjust the patient's medication in order to lower the fall risk.

Intervention condition

Patient Portal DEVICE

A patient portal that provides general information on falls and fall risk to the older patients and helps the patient to prepare for the consultation by filling out a Question Prompt List (QPL). The QPL is a list of possibly relevant questions and topics from which the patient can select those that are important to him/her. These will already be sent to the GP before the consultation takes place.

Intervention condition

Eligibility Criteria

• Age: 70 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Older Adult (65+)

You may qualify if:

• Aged 70 years or older
• High fall risk
• Takes at least 1 Fall Risk Increasing Drug (FRID)

Sponsors & Collaborators

• University of Amsterdam: lead

Study Sites (1)

Huisartsenpraktijken

Amsterdam, Netherlands

Location

MeSH Terms

Interventions

Patient Portals

Intervention Hierarchy (Ancestors)

Health Records, Personal; Medical Records; Records; Data Collection; Epidemiologic Methods; Investigative Techniques

Study Officials

• Julia C.M. van Weert

  Amsterdam School for Communication Research (ASCoR), University of Amsterdam

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Prof. dr. Julia van Weert

Study Record Dates

• First Submitted: October 18, 2022
• First Posted: November 9, 2022
• Study Start: November 21, 2022
• Primary Completion: October 30, 2023
• Study Completion: October 30, 2023
• Last Updated: January 10, 2024

Record last verified: 2024-01

Locations

NL (1)