Nurse vs General Practitioner Care for Patients Requesting Same Day Consultations in Primary Care

Study Overview
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Brief Summary
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The purpose of this study is to compare the effectiveness of nursing care in relation to usual medical care in adult patients who demand to be visited the same day in Primary Care Teams in Catalonia, as it is suggested in other countries.

Detailed Description
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The primary care demand is rapidly growing and the family physicians feel overflowed by the demand and their capacity to solve things is limited by lack of time. Many organizational interventions have been planned to solve this problem. One of these is to imply the nurse professional to solve and control health problems that traditionally were the doctor's job. So, to demonstrate the nursing care is as effective as the medical care, we will compare, among both collectives, the 'quality' of care received by patients who ask an appointment for the same day.

Official Title
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Effectiveness of an Intervention in Primary Care: Randomized Controlled Trial Comparing Care for Patients Requesting Same Day Consultations by Nurse Practitioner vs General Practitioners

Conditions
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Acute Disease, Nursing Care, Ambulatory Care, Family Practice

Intervention / Treatment
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* Procedure: Nurse practitioner care of patients


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients requesting same day consultations in primary care assigned to the practice Exclusion Criteria: do not want to participate difficulties to follow-up serious illness that makes the intervention impossible home visits

Ages Eligible for Study
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Minimum Age: 15 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

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


Arms and Interventions

| Intervention/Treatment |
| --- |
|Procedure: Nurse practitioner care of patients|nan|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Description of the capacity of resolution of the nurse: |  |  | 
| To determine if there are differences in the proportion of patients that make a second appointment for the same reason in the next 2 weeks, comparing the two groups. |  |  | 
| To determine if there are differences in the resolution of symptoms in 2 weeks after the visit comparing the two groups. |  |  | 
| To determine if there are differences in the proportion of admission to hospital or to emergency room the next 2 weeks comparing the two groups. |  |  | 
| To determine if there are differences in the satisfaction and resolution of the worries about the users state of health in 2 weeks after the visit comparing the two groups. |  |  | 
| To determine if there are differences comparing the two groups in the perceived status of health, perception of the information, received attention, resource utilization and future intention to consult again with the same professional. |  |  | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Description of the clinical demands of the users and their demographic characteristics. |  |  | 
| To identify if there is a type of user in which the effectiveness of the intervention is higher. |  |  | 
| To determine the proportion of users visited by the nurse not having to be visited by the doctor afterwards for that reason. |  |  | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Health Services Research, Nurse Practitioners, Outcome and Process Assessment (Health Care), Patient Acceptance of Health Care, Patient Satisfaction, Primary Health Care, Professional Autonomy