Evaluation of the Effects of Teleconsultations on a Endocrinology Referral List

Study Overview
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Brief Summary
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The aim of this study is evaluate the effects of telephone teleconsultations to primary care physicians (compared to the state's referral protocol) in the referrals waiting list for endocrinological appointments.

Detailed Description
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Rio Grande do Sul state's referral list for endocrinology evaluation in specialized care is highly overloaded. There is currently a referral protocol to select patients how should be referred. It will be evaluated if a intervention of telephone-based teleconsultations provided by the TelessaúdeRS to the primary care physicians can provide additional benefits. TelessaúdeRS is a telehealth program from the University of Rio Grande do Sul. This will be evaluated in a cluster randomized clinical trial.

Official Title
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Evaluation of the Effectivity of Teleconsultations for Improving the Referrals From Primary Care to Specialized Care of Patients With Chronic Endocrinological Conditions

Conditions
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Diabetes Mellitus, Hypothyroidism, Hyperthyroidism, Goiter, Thyroid Nodule, Obesity

Intervention / Treatment
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* Other: Teleconsultation
* Other: Protocol


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients from counties with at least 5 endocrinology referrals waiting appointment. Patients referred from primary care physicians Patients referred because one of the protocol conditions (Diabetes Mellitus, Hypothyroidism, Hyperthyroidism, Goiter, Thyroid nodule, Obesity). Exclusion Criteria: Patients from counties with more than one hundred endocrinology referrals waiting appointment.

Ages Eligible for Study
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Minimum Age: 18 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: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Control<br>Referrals will be evaluated through the state's protocols | Other: Protocol<br>* The informations provided in the referral list will be evaluated through the state's referrals protocols.<br>|
| Experimental: Intervention<br>Referrals will be evaluated through the state's protocols associated with telephone-based teleconsultations. | Other: Teleconsultation<br>* The teleconsultations will be performed by medical doctors, mostly family physicians, but also internists and endocrinologists. The teleconsultations will follow a structured format to discuss some topics on the disease and access the relevant information (based on the state's protocols). The doubts from the primary care physician will be addressed.<br>Other: Protocol<br>* The informations provided in the referral list will be evaluated through the state's referrals protocols.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of consultations authorized | Number of consultations authorized after the evaluation by the control and intervention strategies. | 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of new referrals for endocrinology | Total number of new referrals performed by the county. | 1 year | 
| Adherence to the state's protocols | Number of new referrals for endocrinology with adequate informations according to the state's protocols. | 1 year | 
| Usage of TelessaúdeRS teleconsultations | Total number of calls to TelessaúdeRS hotline (available to every primary care physician working in brazilian public health system) | 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Endocrinology, Referral list, Teleconsultation, Telemedicine, Cluster randomized clinical trial