|- candidate number||16667|
|- NTR Number||NTR4445|
|- ISRCTN||ISRCTN no longer applicable|
|- Date ISRCTN created|
|- date ISRCTN requested|
|- Date Registered NTR||5-mrt-2014|
|- Secondary IDs||2013/556 CMO|
|- Public Title||Van spiegelbeeld naar patiŽnt in beeld|
|- Scientific Title||CVRM improvement in general practice: The added value of patient specific audit and feedback|
|- hypothesis||More patients in primary care will be treated according to (evidence based) guidelines if general practices receive feedback on a patient specific level then if they receive feedback on practice level comparing recipients practice with median performance of all participants. |
|- Healt Condition(s) or Problem(s) studied||Cardiovascular disease, Risk management, Primary care, Quality of Health Care, Audit, Feedback|
|- Inclusion criteria||At practice level: General practices who are contracted by care group in Arnhem for CVRM for more than 21 months.
At patient level:
1) patients on simvastatin treatment with a LDL cholesterol level > 2.5mmol/L
2) patients with a history of stroke on acetylsalicylic acid or carbasalate calcium anticoagulance monotherapy .
3) patients aged 70 and older, without established cardiovascular disease and without chronic heart failure treated with 3 or more antihypertensive drugs.
4) patients with chronic kidney disease and eGFR < 45 ml/min who did not take additional laboratory tests (PTH, Hb, calcium, phosphate).
5) patients with a diastolic blood pressure lower than 70mmHg.
6) patients with established cardiovascular disease not on anticoagulant therapy.|
|- Exclusion criteria||None|
|- mec approval received||yes|
|- multicenter trial||yes|
|- Type||2 or more arms, randomized|
|- planned startdate ||10-jan-2014|
|- planned closingdate||1-jul-2014|
|- Target number of participants||22|
|- Interventions||All practices receive feedback on practice level comparing recipients practice with median performance of all participants. The intervention group also receives feedback on a patient specific level .|
|- Primary outcome||mean difference between intervention group and control group for each indicator score. |
|- Secondary outcome||1)Mean difference between intervention group and control group for the total of indicator scores.
2)Reported experiences of general practices (in the intervention group) who worked with the patient specific feedback.
3) Percentage of patients who did not get a change in treatment regardless the specific feedback.
4) Arguments for choice concerning 3)|
|- Timepoints||28-12-2013 Baseline measurement
January 2014 Intervention practices receive feedback on patient specific level.
March 2014 Intervention practices will be contacted by telephone call to answer questions and check if feedback has arrived.
After these phone calls all practices will receive feedback on practice level comparing recipients practice with median performance of all participants.
01-07-2014 End of the intervention period, data measurement
July 2014 Data analysis: Assessment of difference between intervention group and control group. Assessment of the feedback of general practitioners on the process of patient specific feedback.|
|- Trial web site|
|- status||inclusion stopped: follow-up|
|- CONTACT FOR PUBLIC QUERIES|| K.M. Jakobs|
|- CONTACT for SCIENTIFIC QUERIES|| K.M. Jakobs|
|- Sponsor/Initiator ||Zorggroep Arnhem|
(Source(s) of Monetary or Material Support)
|- Brief summary||We will measure the added value of feedback on patient specific level compared with feedback on practice level. The feedback concerns improving the implementation of 6 specific recommendations in practice guidelines for CVRM. 22 General practices contracted with care group Arnhem on CVRM for at least 21 months participated.|
|- Main changes (audit trail)|
|- RECORD||5-mrt-2014 - 8-apr-2014|