Item request has been placed! ×
Item request cannot be made. ×
loading  Processing Request

Activating GENeral practitioners dialogue with patients on their Agenda (MultiCare AGENDA) study protocol for a cluster randomized controlled trial.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
اقرأ على الانترنت اقرأ أكثر حفظ في قائمتي
  • معلومة اضافية
    • المصدر:
      Publisher: BioMed Central Country of Publication: England NLM ID: 100967792 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2296 (Electronic) Linking ISSN: 14712296 NLM ISO Abbreviation: BMC Fam Pract Subsets: MEDLINE
    • بيانات النشر:
      Original Publication: London : BioMed Central, [2000-2021]
    • الموضوع:
      Physician-Patient Relations*; Chronic Disease/*therapy ; General Practice/*methods ; Patient Participation/*methods ; Patient-Centered Care/*methods; Aged ; Aged, 80 and over ; Communication ; Comorbidity ; Follow-Up Studies ; General Practice/standards ; Germany ; Humans ; Medication Reconciliation ; Outcome Assessment, Health Care ; Patient Care Planning ; Patient Satisfaction ; Polypharmacy
    • نبذة مختصرة :
      Background: This study investigates the efficacy of a complex multifaceted intervention aiming at increasing the quality of care of GPs for patients with multimorbidity. In its core, the intervention aims at enhancing the doctor-patient-dialogue and identifying the patient's agenda and needs. Also, a medication check is embedded. Our primary hypothesis is that a more patient-centred communication will reduce the number of active pharmaceuticals taken without impairing the patients' quality of life. Secondary hypotheses include a better knowledge of GPs about their patients' medication, a higher patient satisfaction and a more effective and/or efficient health care utilization.
      Methods/design: Multi-center, parallel group, cluster randomized controlled clinical trial in GP surgeries.
      Inclusion Criteria: Patients aged 65-84 years with at least 3 chronic conditions.
      Intervention: GPs allocated to this group will receive a multifaceted educational intervention on performing a narrative doctor-patient dialogue reflecting treatment targets and priorities of the patient and on performing a narrative patient-centred medication review. During the one year intervention GPs will have a total of three conversations à 30 minutes with the enrolled patients.
      Control: Care as usual. Follow-up per patient: 14 months after baseline interview. Primary efficacy endpoints: Differences in medication intake and health related quality of life between baseline and follow-up in the intervention compared to the control group. Randomization: Computer-generated by an independent institute. It will be performed successively when patient recruitment in the respective surgery is finished. Blinding: Participants (GPs and patients) will not be blinded to their assignment but will be unaware of the study hypotheses or outcome measures.
      Discussion: There is growing evidence that the phenomenon of polypharmacy and low quality of drug use is substantially due to mis-communication (or non-communication) in the doctor patient interaction. We assume that the number of pharmaceutical agents taken can be reduced by a communicational intervention and that this will not impair the patients' health-related quality of life. Improving communication is a core issue of future interventions, especially for patients with multimorbidity.
      Trial Registration: Current CONTROLled Trials ISRCTN46272088.
    • References:
      Cochrane Database Syst Rev. 2012 Apr 18;(4):CD006560. (PMID: 22513941)
      Lancet. 2007 Jul 14;370(9582):173-184. (PMID: 17630041)
      Z Arztl Fortbild Qualitatssich. 2000 Jan;94(1):21-30. (PMID: 10721161)
      Am J Health Promot. 2006 Jul-Aug;20(6):429-35. (PMID: 16871823)
      BMC Public Health. 2011 Feb 14;11:101. (PMID: 21320345)
      Ageing Res Rev. 2011 Sep;10(4):430-9. (PMID: 21402176)
      Ann Intern Med. 1997 Dec 15;127(12):1097-102. (PMID: 9412313)
      Z Arztl Fortbild Qualitatssich. 2006;100(5):335-43. (PMID: 16955619)
      Am J Geriatr Pharmacother. 2007 Mar;5(1):31-9. (PMID: 17608245)
      Cochrane Database Syst Rev. 2012 May 16;(5):CD008165. (PMID: 22592727)
      Int J Geriatr Psychiatry. 2008 Sep;23(9):963-71. (PMID: 18416451)
      JAMA. 2005 Aug 10;294(6):716-24. (PMID: 16091574)
      Milbank Q. 1996;74(4):511-44. (PMID: 8941260)
      BMJ. 2002 Aug 31;325(7362):472. (PMID: 12202329)
      BMJ. 1999 Jan 2;318(7175):48-50. (PMID: 9872892)
      Patient Educ Couns. 2009 Feb;74(2):135-41. (PMID: 18845412)
      J Am Geriatr Soc. 2009 Mar;57(3):560-1. (PMID: 19278399)
      Health Policy. 1990 Dec;16(3):199-208. (PMID: 10109801)
      BMC Health Serv Res. 2009 Aug 11;9:145. (PMID: 19671164)
    • Molecular Sequence:
      ISRCTN ISRCTN46272088
    • الموضوع:
      Date Created: 20121214 Date Completed: 20130522 Latest Revision: 20240318
    • الموضوع:
      20240318
    • الرقم المعرف:
      PMC3560077
    • الرقم المعرف:
      10.1186/1471-2296-13-118
    • الرقم المعرف:
      23234237