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Reducing vitamin testing in primary care practice


- candidate number26157
- NTR NumberNTR6216
- ISRCTNISRCTN no longer applicable
- Date ISRCTN created
- date ISRCTN requested
- Date Registered NTR5-jan-2017
- Secondary IDs839201002_REVERT 
- Public TitleReducing vitamin testing in primary care practice
- Scientific TitleReducing vitamin testing in primary care practice
- ACRONYMREVERT
- hypothesisThe numbers of diagnostic vitamin D and B12 tests ordered in general practice will reduce by a de-implementation strategy, comprising:
- education of general practitioners using existing guidelines on vitamin D and B12 tests ordering
- techniques for general practitioners to communicate and discuss this topic with their patients
- feedback for practices on numbers of vitamin tests in the previous years
- educational materials for patients
- Healt Condition(s) or Problem(s) studiedVitamin D, Vitamin B12 deficiency, General practitioner
- Inclusion criteriaGeneral practitioners willing to participate in this intervention trial. No individual patients will be included. In total, 30-40 Dutch primary care practices will participate.
- Exclusion criteriaNot relevant, as the intervention is targeted at general practitioners, not at patients.
- mec approval receivedyes
- multicenter trialyes
- randomisedyes
- masking/blindingNone
- controlNot applicable
- groupParallel
- Type2 or more arms, randomized
- Studytypeintervention
- planned startdate 1-feb-2017
- planned closingdate1-feb-2019
- Target number of participants35
- InterventionsThe intervention, targeted at general practitioners, will be a meeting (Diagnostisch Toets Overleg) in which education on existing guidelines for vitamin D and B12 and communication with patients about this topic will be offered by an expert. General practitioners will also receive feedback on the history of vitamin D and B12 tests ordering of their practices. In the other arm, general practitioners have the same educational meeting, and patients in their practices will be informed about this topic using written information material and via screens in the waiting room.
- Primary outcomeThe reduction in diagnostic vitamin D and B12 tests ordered per 1000 patients in the year after the intervention, as compared to the year prior to the intervention.
- Secondary outcomeVarious secondary outcomes will be assessed:
- the results of the ordered vitamin D and B12 tests
- prescriptions of vitamin supplements
- the added value of informing patients in the strategy
- the cost-effectiveness of both strategies
- barriers and facilitators of both strategies, with respect to knowledge, communication, implementation
- re-consultation of patients having requested a vitamin test
- TimepointsPrimary and secondary endpoints will be determined by comparing data from a complete year after the intervention to those from a complete year prior to the intervention. After the intervention, about 10 general practitioners and about 10 patients will be interviewed.
- Trial web site
- statusplanned
- CONTACT FOR PUBLIC QUERIESDr. A.W. Velden, van der
- CONTACT for SCIENTIFIC QUERIESDr. A.W. Velden, van der
- Sponsor/Initiator Julius Center for Health Sciences and Primary Care, Erasmus Medical Center, SALTRO - Doctor Laboratory & Thrombosis Service
- Funding
(Source(s) of Monetary or Material Support)
ZON-MW, The Netherlands Organization for Health Research and Development, Citrienfonds
- PublicationsN/A
- Brief summaryAn every year increasing numbers of vitamin diagnostic tests are being ordered by general practitioners. Often there is no clear clinical reasoning or indication for these tests. Furthermore, this testing has been shown to result in over-diagnosing, over-treatment, medicalization, with very limited health benefits. The REVERT study aims to reduce unnecessary ordering of vitamin D and B12 diagnostic tests in primary care by educating general practitioners about merits and pitfalls of vitamin D and B12 testing and communication about this topic and these tests with their patients. Education will be based on existing, evidence-based current primary care guidelines. The additional value of informing patients will also be investigated.
- Main changes (audit trail)
- RECORD5-jan-2017 - 8-mrt-2017


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