Effectiveness and Implementation of the DINKNESH Digital Palliative Care Tool in Ethiopia

May 4, 2026 updated by: Meheret Y. Amare, Addis Ababa University

Effectiveness and Implementation Determinants of the DINKNESH App Compared to Paper-Based Assessment Tools for Palliative Care: A Mixed-Methods Cluster Randomized Trial in Addis Ababa, Ethiopia

The goal of this clinical trial is to learn if a digital health app called DINKNESH is effective for palliative care identification compared to traditional paper-based assessment tools. It will also look at the factors that help or hinder the use of this app in primary care settings.

The main questions it aims to answer are:

Does the DINKNESH app improve palliative care assessments compared to paper forms?

What are the main barriers and facilitators for Health Extension Workers when using the app in their daily work?

We will compare the DINKNESH app to standard paper-based tools to see if digital tools improve clinical assessment and implementation.

Participants will:

Be assessed for palliative care needs using either the DINKNESH mobile app or standard paper forms.

Receive routine follow-up care as determined by their health provider.

(For health workers): Participate in interviews or surveys to discuss their experience using the assigned assessment tool.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

1440

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria

  • For patients(Quantitative Part):

    • Adults aged 18 years or older
    • Currently diagnosed with one or more chronic conditions and receiving home-based follow-up care from a participating Family Health Team within the catchment area of a selected study cluster
    • Willing to provide verbal informed consent, or has a primary caregiver willing to provide proxy consent

  • For healthcare workers:

    • Staff members of the Family Health Team at the selected clusters
    • Involved in delivering or supervising palliative care services during the study period
    • For the qualitative part: Participated in the DINKNESH App implementation process and is willing to participate in a Focus Group Discussion (FGD)

Exclusion Criteria

  • For patients

    • Patients whose clinical condition prevents both self-participation and proxy participation in the assessment process
    • Patients already formally identified and referred for palliative care prior to the study period

  • For healthcare workers:

    • Staff members planning to be absent for more than 1 day during the six-week active study period
    • Healthworkers not present during the training session

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: DINKNESH App
Healthcare workers (Family Health Teams) in these clusters will utilize the DINKNESH mobile application during routine home-based visits to systematically identify and assess patients requiring palliative care. The app integrates validated tools (SPICT, ECOG, IPOS) and provides clinical decision support for symptom management, counseling, and referral protocols
Other: DINKNESH App
A mobile-based digital health application designed to support Family Health Teams in the systematic identification and assessment of patients with palliative care needs. The application digitizes validated clinical tools, including the Supportive and Palliative Care Indicators Tool (SPICT), the Eastern Cooperative Oncology Group (ECOG) performance status, and the Integrated Palliative care Outcome Scale (IPOS) along with reference materials
Active Comparator: Paper based Tool
Family Health Teams in these clusters will provide home-based chronic care services following standard paper based without the use of the digital application.
Other: Paper based tool
A paper-based clinical assessment protocol designed to support Family Health Teams in the systematic identification and assessment of patients with palliative care needs. It incorporates the same validated clinical tools used in the intervention arm, including the Supportive and Palliative Care Indicators Tool (SPICT), the Eastern Cooperative Oncology Group (ECOG) performance status, and the Integrated Palliative care Outcome Scale (IPOS), administered manually during routine home visits without the use of a digital application and reference material.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Rate of identification of patients with palliative care needs.
Time Frame: 6 weeks
The primary outcome is the rate of palliative care identifications, calculated as the number of individuals identified as requiring palliative care divided by the total number of chronic patient visit conducted by the Family Health Teams during the study period.
6 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Qualitative assessment of implementation barriers and enablers.
Time Frame: 6 weeks
Evaluation of implementation determinants (barriers and facilitators) through focus group discussions with health extension workers
6 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Addis Ababa University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

April 1, 2026

Primary Completion (Estimated)

May 1, 2026

Study Completion (Estimated)

May 1, 2026

Study Registration Dates

First Submitted

March 20, 2026

First Submitted That Met QC Criteria

May 4, 2026

First Posted (Actual)

May 7, 2026

Study Record Updates

Last Update Posted (Actual)

May 7, 2026

Last Update Submitted That Met QC Criteria

May 4, 2026

Last Verified

February 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • MPH/039/18

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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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