Clinical trial NCT00461201: Nurse vs General Practitioner Care for Patients Requesting Same Day Consultations in Primary Care
Official title: Effectiveness of an Intervention in Primary Care: Randomized Controlled Trial Comparing Care for Patients Requesting Same Day Consultations by Nurse Practitioner vs General Practitioners
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Acute Disease
Nursing Care
Ambulatory Care
Family Practice
Keywords: Health Services Research
Nurse Practitioners
Outcome and Process Assessment (Health Care)
Patient Acceptance of Health Care
Patient Satisfaction
Primary Health Care
Professional Autonomy
Lead sponsor: Catalan Institute of Health
Sponsor class: OTHER_GOV
Collaborators: name: Carlos III Health Institute
name: Ministry of Health
name: Fundacio d'Investigacio en Atencio Primaria Jordi Gol i Gurina
First posted: 2007-04-17
Enrollment: 1640
Sex: ALL
Minimum age (years): 15
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: 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: 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.

Eligibility criteria: 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

Primary outcomes:
measure: Description of the capacity of resolution of the nurse:
measure: 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.
measure: To determine if there are differences in the resolution of symptoms in 2 weeks after the visit comparing the two groups.
measure: 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.
measure: 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.
measure: 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 outcomes:
measure: Description of the clinical demands of the users and their demographic characteristics.
measure: To identify if there is a type of user in which the effectiveness of the intervention is higher.
measure: To determine the proportion of users visited by the nurse not having to be visited by the doctor afterwards for that reason.
Other outcomes:
Locations:
Study officials:
affiliation: Catalan Institute of Health
name: Begoña Iglesias, Physician
role: PRINCIPAL_INVESTIGATOR
affiliation: Catalan Institute of Health
name: Maria Teresa Grifell, Nurse
role: STUDY_CHAIR
affiliation: Catalan Institute of Health
name: Josep Maria Vidal, Physician
role: STUDY_CHAIR
affiliation: Catalan Institute of Health
name: Sandra Pons, Physician
role: STUDY_CHAIR
affiliation: Catalan Institute of Health
name: Josep Casajuana, Physician
role: STUDY_CHAIR
affiliation: Catalan Institute of Health
name: Rosa Aragonès, Physician
role: STUDY_CHAIR
affiliation: Catalan Institute of Health
name: Mireia Fàbregas, Physician
role: STUDY_CHAIR
affiliation: Catalan Institute of Health
name: Neus Esgueva, Nurse
role: STUDY_CHAIR
affiliation: Catalan Institute of Health
name: Anna Calvet, Physician
role: STUDY_CHAIR
affiliation: Catalan Institute of Health
name: Maria Teresa Duran, Nurse
role: STUDY_CHAIR
affiliation: Catalan Institute of Health
name: Cristina Gallardo, Pysician
role: STUDY_CHAIR
affiliation: Catalan Institute of Health
name: Maria Assumpció Jiménez, Nurse
role: STUDY_CHAIR
affiliation: Catalan Institute of Health
name: Francisca Ramos, Physician
role: STUDY_CHAIR
affiliation: Catalan Institute of Health
name: Pere Joan Cortés, Physician
role: STUDY_CHAIR
affiliation: Catalan Institute of Health
name: Maria José Garcia, Physician
role: STUDY_CHAIR
affiliation: Catalan Institute of Health
name: Amparo Romaguera, Physician
role: STUDY_CHAIR
affiliation: Catalan Institute of Health
name: Soledad Romea, Physician
role: STUDY_CHAIR
affiliation: Catalan Institute of Health
name: Hèlia Cebrián, Nurse
role: STUDY_CHAIR
affiliation: Catalan Institute of Health
name: Jeannine Hernández, Physician
role: STUDY_CHAIR
affiliation: Catalan Institute of Health
name: Ramon Morera, Physician
role: STUDY_CHAIR
affiliation: Catalan Institute of Health
name: Manel Ferran, Physician
role: STUDY_CHAIR
affiliation: Catalan Institute of Health
name: Isabel Rosich, Farmacy
role: STUDY_CHAIR
affiliation: Catalan Institute of Health
name: Maria Carmen Sanchez, Nurse
role: STUDY_CHAIR
References:
citation: Effectiveness of health checks conducted by nurses in primary care: final results of the OXCHECK study. Imperial Cancer Research Fund OXCHECK Study Group. BMJ. 1995 Apr 29;310(6987):1099-104.
citation: Mundinger MO, Kane RL, Lenz ER, Totten AM, Tsai WY, Cleary PD, Friedewald WT, Siu AL, Shelanski ML. Primary care outcomes in patients treated by nurse practitioners or physicians: a randomized trial. JAMA. 2000 Jan 5;283(1):59-68. doi: 10.1001/jama.283.1.59.
citation: Kinnersley P, Anderson E, Parry K, Clement J, Archard L, Turton P, Stainthorpe A, Fraser A, Butler CC, Rogers C. Randomised controlled trial of nurse practitioner versus general practitioner care for patients requesting "same day" consultations in primary care. BMJ. 2000 Apr 15;320(7241):1043-8. doi: 10.1136/bmj.320.7241.1043.
citation: Venning P, Durie A, Roland M, Roberts C, Leese B. Randomised controlled trial comparing cost effectiveness of general practitioners and nurse practitioners in primary care. BMJ. 2000 Apr 15;320(7241):1048-53. doi: 10.1136/bmj.320.7241.1048.
citation: Shum C, Humphreys A, Wheeler D, Cochrane MA, Skoda S, Clement S. Nurse management of patients with minor illnesses in general practice: multicentre, randomised controlled trial. BMJ. 2000 Apr 15;320(7241):1038-43. doi: 10.1136/bmj.320.7241.1038.
citation: Horrocks S, Anderson E, Salisbury C. Systematic review of whether nurse practitioners working in primary care can provide equivalent care to doctors. BMJ. 2002 Apr 6;324(7341):819-23. doi: 10.1136/bmj.324.7341.819.
citation: Zwarenstein M, Bryant W. Interventions to promote collaboration between nurses and doctors. Cochrane Database Syst Rev. 2000;(2):CD000072. doi: 10.1002/14651858.CD000072.