PEARL Study: Improvement of Non-Hodgkin's Lymphoma Care
Improvement of Hospital Care for Patients With Non-Hodgkin's Lymphoma
연구 개요
상세 설명
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.
연구 유형
등록 (예상)
단계
- 해당 없음
연락처 및 위치
연구 장소
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Gelderland
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Nijmegen, Gelderland, 네덜란드, 6500 HB
- Radboud University Nijmegen Medical Center
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참여기준
자격 기준
공부할 수 있는 나이
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
설명
Inclusion Criteria:
- Clinical diagnosis of non-Hodgkin lymphoma
- Diagnosed in one of the participating hospitals
- Able to read and understand Dutch
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 건강 서비스 연구
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 없음(오픈 라벨)
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
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활성 비교기: Standard implementation strategy
Standard intervention
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Standard intervention consists of audit&feedback
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실험적: Innovative implementation strategy
Implementation tools
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연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
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Change from baseline in adherence to quality indicators for NHL care
기간: 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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2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
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Exposure to and experiences with the interventions
기간: 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
기간: 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
기간: 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)
기간: 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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공동 작업자 및 조사자
수사관
- 수석 연구원: Rosella Hermens, PhD, Radboud University Nijmegen Medical Center
- 수석 연구원: Nelleke Ottevanger, MD, PhD, Radboud University Nijmegen Medical Center
간행물 및 유용한 링크
일반 간행물
- 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.
연구 기록 날짜
연구 주요 날짜
연구 시작
기본 완료 (실제)
연구 완료 (예상)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (추정)
연구 기록 업데이트
마지막 업데이트 게시됨 (추정)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
이 연구와 관련된 용어
기타 연구 ID 번호
- ZonMW 171103002
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