Improved Delivery of Cardiovascular Preventive Care (IDOCC) Through Outreach Facilitation
试验速览
- 阶段
- 1 期
- 状态
- 已完成
- 发起方
- 入组人数
- 194
- 试验地点
- 2
- 主要终点
- Quality of care process index = ∑ of recommended services received by patient/ ∑ of the recommended services for which the patient was eligible
研究概览
简要总结
The aim of the proposed study is to implement and evaluate Outreach Facilitation as a means to increase the uptake of evidence-based practice for secondary prevention and management of patients with established CVD and cardiovascular risk factors, in primary care practices throughout the Champlain LHIN. This initiative centers on the use of an Outreach Facilitation Model, in which skilled health professionals known as facilitators (Practice Change Consultants) serve as an expert resource to primary care practices in three areas: a) practice performance assessment, feedback, and consensus building towards goal setting and implementation; b) clinical, technical, organizational resources and practical advice; and c) encouragement to face and move through the challenges associated with implementing system change.
详细描述
General practice visits can provide a unique opportunity to identify and treat individuals with or at risk for CVD. We plan to test implementation of system changes using nurse facilitation in the organization of primary care practices to enhance daily adoption by the practice staff of evidence-based guidelines and prevention strategies that can lead to better patient care.
Specifically, we will:
i) Establish an Outreach Facilitation program in primary care practices throughout the Champlain District to improve the secondary prevention and management of cardiovascular disease in the primary care setting. The program will assist the practices (Champlain CVD Prevention Network) with implementation of evidence-based guidelines (Champlain Primary Care CVD Prevention Guidelines) by targeting the following risk factors:
- Hypertension
- Dyslipidemia
- Diabetes
- Chronic Kidney Disease
- Smoking
- Obesity
- Physical Inactivity
ii) Rigorously evaluate this program's efficacy and cost effectiveness
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Single Group
- 主要目的
- Health Services Research
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 40 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Men and women over 40 years of age, who meet at least one of the following criteria:
- •have established cardiovascular disease: Coronary Artery Disease, Cerebrovascular disease (documented stroke and/or TIA), and Peripheral Vascular Disease;
- •have Diabetes Mellitus;
- •have Chronic Kidney Disease ;
- •are at high risk for CVD based on a presence of at least three of the following established cardiovascular risk factors: age (males ≥ 45, females ≥ 55), smoker status, hypertension, and dyslipidemia.
- •No restrictions will be imposed on the recruitment process; all practices in the region will be eligible to participate.
排除标准
- •see above
结局指标
主要结局
Quality of care process index = ∑ of recommended services received by patient/ ∑ of the recommended services for which the patient was eligible
时间窗: 5 years
次要结局
- Quality of care outcome index = ∑ of recommended targets reached / ∑ of the number of targets for which the patient is eligible based on the number of conditions suffered by the patient(5 years)
研究者
Dr. William Hogg
Dr.
C. T. Lamont Primary Care Research Centre