Clinical trial NCT03426475: Effect of Strategies to Improve General Practitioner-nurse Collaboration and Communication
Official title: Effects of Strategies to Improve General Practitioner-nurse Collaboration and Communication in Regard to Hospital Admissions of Nursing Home Residents.
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Utilization of Medical Care by Nursing Home Residents
Keywords: nursing home residents
interprofessional collaboration
reduction of hospitalisation
Lead sponsor: University Medical Center Goettingen
Sponsor class: OTHER
First posted: 2018-02-08
Enrollment: 680
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: SUPPORTIVE_CARE

Brief summary: Previously,six measures were developed for a better collaboration of general practitioners and nurses in nursing homes in a qualitative multistep bottom-up process. These measures, summarised as the interprof ACT intervention, shall improve the flow of information and the communication between the involved parties and lead to more transparency and effectiveness regarding treatment decisions of nursing home residents.The major aim of this trial is to examine the clinical effectiveness of interprof ACT. The main hypothesis is that implementation of interprof ACT reduces the cumulative incidence of hospitalisations of nursing home residents within 12 months from 50% to 35% (15% absolute reduction).


Eligibility criteria: Inclusion Criteria Residents:

* at least one GP visit in recent three months or
* two GP visits in recent 6 months or
* admission to the nursing home during the precedent 6 months independently of documented GP contacts
* at least 18 years of age
* written informed consent by the resident or her/his legal guardian

Inclusion Criteria Nursing Homes:

* minimum size of 40 residents
* written consent provided by the nursing home Manager Prior to randomisation

Exclusion Criteria Residents:

- admission for short term care only

Exclusion Criteria Nursing Homes:

- participation in other projects on interprofessional collaboration.

Primary outcomes:
measure: cumulative number of hospitalisation
timeFrame: within 12 months
Secondary outcomes:
measure: absolute number of hospitalisations
timeFrame: within 12 months
measure: hospital days
timeFrame: within 12 months
measure: mortality
timeFrame: within 12 months
measure: potentially inadequate medications
timeFrame: baseline and after 6 and 12 months
measure: Adverse Events
timeFrame: within 12 months
measure: Quality of Life in Alzheimer's Disease scale - Nursing Home version (QoL-AD-NH)
timeFrame: baseline and after 12 months
measure: Health-related Quality of Life (HRQL) of residents measured by EQ-5D-5L
timeFrame: baseline and after 12 months
measure: medical services
timeFrame: within 12 months
measure: economic evaluation: efficiency
timeFrame: after 12 months
measure: Quality of inter-professional collaboration according to the Partnership Self-Assessment Tool (PSAT) score
timeFrame: after 12 months
measure: Attitudes towards inter-professional collaboration according to the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration (JSAPNC) score
timeFrame: after 12 months
Other outcomes:
Locations:
city: Göttingen
country: Germany
facility: Department of General Practice, University Medical Center Göttingen
city: Göttingen
country: Germany
facility: Organization and Corporate Development, Georg August University Göttingen
city: Hamburg
country: Germany
facility: Department of General Practice/Primary Care, University Medical Center Hamburg-Eppendorf
city: Lübeck
country: Germany
facility: Institute for Social Medicine and Epidemiology, Nursing Research Group,University of Lübeck
Study officials:
affiliation: Department of General Practice, University Medical Center Goettingen
name: Eva Hummers, Prof. Dr. med.
role: PRINCIPAL_INVESTIGATOR
References:
citation: Steyer L, Kortkamp C, Muller C, Tetzlaff B, Fleischmann N, Weber CE, Scherer M, Kuhn A, Jarchow AM, Luth F, Kopke S, Friede T, Konig HH, Hummers E, Maurer I, Balzer K. Implementation, mechanisms of change and contextual factors of a complex intervention to improve interprofessional collaboration and the quality of medical care for nursing home residents: study protocol of the process evaluation of the interprof ACT intervention package. Trials. 2022 Jul 8;23(1):561. doi: 10.1186/s13063-022-06476-6.
citation: Muller C, Hesjedal-Streller B, Fleischmann N, Tetzlaff B, Mallon T, Scherer M, Kopke S, Balzer K, Gartner L, Maurer I, Friede T, Konig HH, Hummers E. Effects of strategies to improve general practitioner-nurse collaboration and communication in regard to hospital admissions of nursing home residents (interprof ACT): study protocol for a cluster randomised controlled trial. Trials. 2020 Nov 5;21(1):913. doi: 10.1186/s13063-020-04736-x.