PEARL Study: Improvement of Non-Hodgkin's Lymphoma Care
Improvement of Hospital Care for Patients With Non-Hodgkin's Lymphoma
調査の概要
詳細な説明
In a previous study among 22 Dutch hospitals many gaps in the care for patients with non-Hodgkin's lymphomas (NHL) were found, compared to best evidence as described in guidelines. In a problem analysis study, barriers and facilitators for good quality of NHL-care were assessed and a tailored implementation strategy was developed, based on these findings. The proposed study aims at the effectiveness, feasibility and costs of this tailored strategy to improve quality of care for patients with an NHL in a clustered randomized controlled trial in 19 Dutch hospitals.
Multilevel regression analyses will be performed to evaluate the effectiveness of both strategies. Exposure to and experiences with the strategy elements will be analysed descriptively.
Regarding the costs, the two strategies are compared with a health care perspective. The input of resources will be assessed by collecting volumes of consumed resources and multiplying these by the price of each resource unit; the implementation process and consequently costs will be estimated by an Activity Based Costing (ABC) approach. The output will be determined by the level of adherence to the NHL quality indicators.
研究の種類
入学 (予想される)
段階
- 適用できない
連絡先と場所
研究場所
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Gelderland
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Nijmegen、Gelderland、オランダ、6500 HB
- Radboud University Nijmegen Medical Center
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Clinical diagnosis of non-Hodgkin lymphoma
- Diagnosed in one of the participating hospitals
- Able to read and understand Dutch
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：ヘルスサービス研究
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：なし（オープンラベル）
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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アクティブコンパレータ：Standard implementation strategy
Standard intervention
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Standard intervention consists of audit&feedback
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実験的：Innovative implementation strategy
Implementation tools
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Change from baseline in adherence to quality indicators for NHL care
時間枠：baseline and 1 year
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The effect of our interventions will be measured by means of adherence to quality indicators for optimal NHL care.
The effects of the audit and feedback strategy (9 hospitals) versus the tailored strategy (9 hospitals) will be evaluated using previously developed quality indicators.
These indicators for optimal NHL care were developed on the basis of evidence based guidelines, literature and opinions of clinicians about NHL care in a previous study and were validated.
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baseline and 1 year
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Exposure to and experiences with the interventions
時間枠：after 1 year
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To study the feasibility of both strategies, a process evaluation has to give insight into the mechanisms and processes responsible for the result (= extent of adherence to the indicator set for optimal NHL care).
The actual 'exposure' of the patients and professionals to the implementation elements, together with their experience with these elements may have influenced the final result (success or failure of adherence).
Data about 'exposure' to the different interventions will be collected using questionnaires.
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after 1 year
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Costs of the strategy and the changed care
時間枠：after 1 year
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Non-adherence to the multidisciplinary NHL guideline may lead to unnecessary medical interventions and more complications, and subsequently to efficiency losses.
This economic evaluation compares the two implementation strategies.
The perspective of this economic evaluation will be a health care perspective.
Both the costs of the implementation strategy and changes in health care consumption will be assessed.
The outcome should facilitate local health care decision making on implementation.
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after 1 year
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Change from baseline in morbidity
時間枠：baseline and 1 year
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Morbidity is an important outcome measure for the effect of the intervention strategy.
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baseline and 1 year
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Differences between both groups in Patient Related Outcome Measures (PROMs)
時間枠：after 1 year
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Patient Related Outcome Measures as quality of life are important measures to evaluate the outcome of care from a patient perspective.
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after 1 year
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協力者と研究者
捜査官
- 主任研究者：Rosella Hermens, PhD、Radboud University Nijmegen Medical Center
- 主任研究者：Nelleke Ottevanger, MD, PhD、Radboud University Nijmegen Medical Center
出版物と役立つリンク
一般刊行物
- Stienen JJ, Hermens RP, Wennekes L, van de Schans SA, Dekker HM, Blijlevens NM, van der Maazen RW, Adang EM, van Krieken JH, Ottevanger PB. Improvement of hospital care for patients with non-Hodgkin's lymphoma: protocol for a cluster randomized controlled trial (PEARL study). Implement Sci. 2013 Jul 9;8:77. doi: 10.1186/1748-5908-8-77.
- Stienen JJ, Ottevanger PB, Wennekes L, van de Schans SA, Dekker HM, Blijlevens NM, van der Maazen RW, van Krieken JH, Hermens RP. Delivering high-quality care to patients with a non-Hodgkin's lymphoma: barriers perceived by patients and physicians. Neth J Med. 2014 Jan;72(1):41-8.
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (予想される)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
その他の研究ID番号
- ZonMW 171103002
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