- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06061172
Digital Tool Enhancing GPs' Information Management for Patients With Multimorbidity - a Pilot Study (gp-multitool)
Evaluation of a Digital Tool Enhancing GPs' Information Management in the Treatment of Patients With Multimorbidity - a Pilot Study (Gp-multitool)
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The gp-multitool.de study is a cluster-randomized controlled trial that enhances evidence-based and patient-centered care for patients with multimorbidity by assessing and providing information relevant for the primary care of this patient group. It aims to reduce the time patients spend in hospital (primary outcome) and their outpatient health care use, and to improve process quality of care, patients' health-related quality of life, and patient satisfaction (secondary outcomes).
This cluster-randomized controlled pilot study examines the feasibility of the gp-multitool.de study, i.e., intervention and evaluation in GP practices. Specifically, the aims of the pilot study are 1. to pilot the gp-multitool.de intervention over six months and to test acceptance, functionality, reliability and usability in general practices under real world conditions, 2. to assess feasibility of the study design, i.e., recruitment of practices and patients, baseline data acquisition, randomization, implementation of the intervention, and outcome data acquisition, and 3. to provide data for the final sample size calculation of the evaluation study.
GPs in the intervention group receive access to the digital tool, together with a brief introduction to its functionalities, a written manual, and contact data of a telephone support hotline, which can be called in case of any technical or organizational problems in relation to the digital tool. GPs in the control group receive no intervention and provide care as usual.
Patients will be recruited from GP practices in urban and rural administrative districts in Germany. The gp-multitool.de study is based on telephone interviews of patients and their GPs. Practices will be randomized after the baseline assessment by an independent statistician who does not have access to the assessed patient and practice data. The primary outcome will be analyzed using a multilevel mixed-effects negative-binomial regression model, and secondary outcomes will be analyzed by multilevel mixed-effects linear and negative-binomial regression models.
In addition to quantitative data collection, a qualitative process evaluation with all participating GPs and one patient from each practice will be conducted based on a pre-defined semi-structured interview guide. The process evaluation will focus on compliance with the study protocol, problems with functionality, usability and reliability of the tool and possible sources of bias in the study. The interviews will be digitally recorded, transcribed verbatim and analyzed by qualitative content analysis.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Julia Nothacker, M. Sc.
- Phone Number: +49-40-7410-57161
- Email: j.nothacker@uke.de
Study Locations
-
-
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Hamburg, Germany, 20246
- Recruiting
- Universitätsklinikum Hamburg-Eppendorf
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- participation in a DMP; in Germany, DMPs have been implemented in outpatient care for asthma, breast neoplasms, coronary heart disease, diabetes mellitus type 1, diabetes mellitus type 2, and chronic obstructive pulmonary disease
- at least two of the following coexisting conditions: Hypertension, Lipid metabolism disorders, Chronic low back pain, Severe vision reduction, Joint arthrosis, Diabetes mellitus, Chronic ischemic heart disease, Thyroid dysfunction, Cardiac arrhythmias, Obesity, Hyperuricemia/Gout, Prostatic hyperplasia, Lower limb varicosis, Liver diseases, Depression, Asthma/COPD, Gynaecological problems, Atherosclerosis/PAOD, Osteoporosis, Renal insufficiency, Cerebral ischemia/Chronic stroke, Cardiac insufficiency, Severe hearing loss, Chronic cholecystitis/Gallstones, Somatoform disorders, Hemorrhoids, Intestinal diverticulosis, Rheumatoid arthritis/Chronic polyarthritis, Cardiac valve disorders, Neuropathies, Dizziness, Dementias, Urinary incontinence, Urinary tract calculi, Anemias, Anxiety, Psoriasis, Migraine/chronic headache, Parkinson's disease, Cancers, Allergies, Chronic gastritis/GERD, Sexual dysfunction, Insomnia, Tobacco abuse, Hypotension
Exclusion Criteria:
- no capacity to consent
- functional limitations precluding participation in the intervention (eg, loss of vision)
- functional limitations precluding participation in telephone interviews (eg, loss of hearing)
- limited German language skills precluding participation in telephone interviews
- no access to a personal device with access to the internet (i.e., smartphone, tablet or personal computer)
- participation in other trials during the observation time of the pilot study
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
No Intervention: Control group
Care as usual
|
|
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.
|
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:
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. |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
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.
|
Once at baseline (before randomization of practices) and once at follow-up (immediately after the intervention)
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
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.
|
Once at baseline (before randomization of practices) and once at follow-up (immediately after the intervention)
|
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.
|
Once at baseline (before randomization of practices) and once at follow-up (immediately after the intervention)
|
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.
|
Once at baseline (before randomization of practices) and once at follow-up (immediately after the intervention)
|
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.
|
Once at baseline (before randomization of practices) and once at follow-up (immediately after the intervention)
|
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.
|
Once at baseline (before randomization of practices) and once at follow-up (immediately after the intervention)
|
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.
|
Once at baseline (before randomization of practices) and once at follow-up (immediately after the intervention)
|
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.
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Once at baseline (before randomization of practices) and once at follow-up (immediately after the intervention)
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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)
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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.
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Once at baseline (before randomization of practices) and once at follow-up (immediately after the intervention)
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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.
|
Once at baseline (before randomization of practices) and once at follow-up (immediately after the intervention)
|
Collaborators and Investigators
Investigators
- Principal Investigator: Ingmar Schäfer, PD Dr., Universitätsklinikum Hamburg-Eppendorf
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Myocardial Ischemia
- Heart Diseases
- Cardiovascular Diseases
- Vascular Diseases
- Glucose Metabolism Disorders
- Metabolic Diseases
- Skin Diseases
- Respiratory Tract Diseases
- Immune System Diseases
- Neoplasms
- Autoimmune Diseases
- Lung Diseases
- Neoplasms by Site
- Endocrine System Diseases
- Disease Attributes
- Breast Diseases
- Lung Diseases, Obstructive
- Chronic Disease
- Coronary Disease
- Diabetes Mellitus
- Diabetes Mellitus, Type 2
- Breast Neoplasms
- Diabetes Mellitus, Type 1
- Pulmonary Disease, Chronic Obstructive
Other Study ID Numbers
- 2022-100786-BO-ff
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ANALYTIC_CODE
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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