Clinical trial NCT03075709: The Development, Implementation and Evaluation of Clinical Pathways for Chronic Obstructive Pulmonary Disease (COPD) in Saskatchewan
Official title: The Development, Implementation and Evaluation of Clinical Pathways for Chronic Obstructive Pulmonary Disease (COPD) in Saskatchewan
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Pulmonary Disease, Chronic Obstructive
Keywords: Clinical Pathway
CPW
Chronic Obstructive Pulmonary Disease
COPD
Protocol
Adherence
Readmission
Length of Stay
Cost
Lead sponsor: University of Saskatchewan
Sponsor class: OTHER
Collaborators: name: Lung Association of Saskatchewan
name: Novartis
First posted: 2017-03-09
Enrollment: 800
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Observational model: OTHER
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: The intervention will be implemented at the health region level and will therefore include all individuals diagnosed with chronic obstructive pulmonary disease (COPD) residing within a control or intervention health region.

Brief summary: Chronic obstructive pulmonary disease (COPD) has substantial economic and human costs. To minimize these costs high quality guidelines have been developed. However, development of guidelines alone rarely results in changes to practice. One method of integrating guidelines into professional practice is the use of clinical pathways (CPWs).

The investigators are working with local stakeholders to develop CPWs for COPD with the aims of improving quality of care and guideline adherence while reducing healthcare utilization. The CPWs will utilize several steps including: standardizing diagnostic training, implementing and unifying common components of chronic disease care, coordinating the provision of education and reconditioning programs, and ensuring disease specific care utilizes and delivers evidence-informed practices. In addition, the investigators have worked to identify evidence-informed strategies for the implementation of the CPWs. Efforts are underway to tailor these implementation strategies for the local context.

The investigators will conduct a three-year quantitative health services research project using an interrupted time series (ITS) design in the form of a multiple baseline approach with control groups. The CPW will be implemented in two Saskatchewan health regions (experimental groups) and two health regions will act as controls (control groups). The experimental and control groups will each contain one urban and one rural health region.

This project is expected to improve quality of life and reduce healthcare utilization. The project will also provide evidence on the effects of CPWs in both urban and rural settings. If the pathways are found effective the investigators will work with all stakeholders to implement similar CPWs for the remaining health regions in the province.


Eligibility criteria: Inclusion Criteria:

* All individuals with diagnosed chronic obstructive pulmonary disease (COPD)

Exclusion Criteria:

* N/A

Primary outcomes:
measure: Quality of Care
timeFrame: 36 months
Secondary outcomes:
measure: Healthcare Utilization
timeFrame: 36 months
measure: Guideline Adherence
timeFrame: 36 months
Other outcomes:
Locations:
city: Regina
country: Canada
facility: Regina Qu'Appelle Health Region
state: Saskatchewan
Study officials:
References:
citation: Rotter T, Plishka C, Hansia MR, Goodridge D, Penz E, Kinsman L, Lawal A, O'Quinn S, Buchan N, Comfort P, Patel P, Anderson S, Winkel T, Lang RL, Marciniuk DD. The development, implementation and evaluation of clinical pathways for chronic obstructive pulmonary disease (COPD) in Saskatchewan: protocol for an interrupted times series evaluation. BMC Health Serv Res. 2017 Nov 28;17(1):782. doi: 10.1186/s12913-017-2750-x.