Evaluation of Case Management to Improve the Outpatient Care of Alcohol-related Disorders

Study Overview
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Brief Summary
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The purpose of this study is to disseminate and transfer the comprehensive quality management interventions (CQM) for alcohol-related disorders in primary care developed during the first funding phase into routine care. The two steps are (1) to optimize the CQM approach and (2) to investigate the dissemination and transfer into routine care in a randomized controlled trial.

Detailed Description
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In the first funding phase the project AQAH (Ambulantes Qualitätsmanagement alkoholbezogener Störungen in der hausärztlichen Praxis-comprehensive quality management for alcohol-related disorders in primary care) systematically investigated three issues: (1) the outpatient care system and evidence-base for screening, diagnosis and treatment was examined; it developed (2) a comprehensive quality management system (CQM) consisting of documentation material, a pathway of care and evidence-based practice guidelines; (3) the effects of the CQM on the detection and treatment of alcohol-related disorders were investigated in a randomized controlled pre-post design and the results show positive effects of the CQM. In the second funding phase (a 3 year bi-center project) the purpose is now to disseminate and transfer the CQM into routine care. The two steps are (1) to optimize the CQM approach and (2) to investigate the dissemination and transfer into routine care in a randomized trial. (1) The paper-based AQAH-practice guidelines are transformed into an interactive electronic version with online patient documentation and evaluation, decision support measures as well as links to specialists and an e-learning tool. (2) After pilot testing in the AQAH-study-networks, an active transfer to the greater regions of Südbaden and Südwürttemberg will be performed in a parallel group cluster randomized controlled trial with GP practices as unit of randomization. Outcome data will be collected concerning the acceptance of the system and the quality of care delivered. Comparison(s): (1) Use of the interactive electronic version of the CQM for alcohol-related disorders with a special training for general practitioners, compared to (2) use of the CQM with additional education for the whole practice team and organizational re-structuring advice, compared to (3) a control group who uses the CMQ without any special training.

Official Title
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Comprehensive Quality Management in Out-patient Care for Alcohol-related Disorders (AQAH). Transfer and Dissemination Into Routine Practice

Conditions
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Alcohol-related Disorders

Intervention / Treatment
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* Procedure: Online Comprehensive Quality Management System (CQM) of alcohol-related disorders in primary care
* Procedure: Physician training
* Procedure: Practice team training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: General practitioner Possibility to use broad-band internet Exclusion Criteria: none
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: 1<br> | Procedure: Online Comprehensive Quality Management System (CQM) of alcohol-related disorders in primary care<br> <br> Procedure: Physician training<br> <br> |
| Experimental: 2<br> | Procedure: Online Comprehensive Quality Management System (CQM) of alcohol-related disorders in primary care<br> <br> Procedure: Physician training<br> <br> Procedure: Practice team training<br> <br> |
| Active Comparator: 3<br> | Procedure: Online Comprehensive Quality Management System (CQM) of alcohol-related disorders in primary care<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Acceptance of the CQM-system: Number of actively participating practices |  |  | 
| Adherence to the system: relative numbers of screened, documented and followed-up patients |  |  | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Quality of care provided: Patients that are adequately treated and followed-up |  |  | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Quality of Health Care, Primary Health Care, Education, E-Learning, Alcohol-related Disorders