Strategies to Improve Appropriate Referral to Rheumatologists
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 544
- 试验地点
- 2
- 主要终点
- Percentage of appropriate referred patients
研究概览
简要总结
The aim of this cluster randomized controlled trial is to improve the number of effectively referred patients with IRD to the rheumatology outpatient clinic with either use of validated referral pro formas or triage of IRD by specialists in a primary care setting compared to usual care. In addition, the investigators want to provide tools for the general practitioner to recognise IRD and improve early referral of patients with IRD, and a cost-effectiveness analysis will be performed to evaluate the decreasing effect on health-care cost.
详细描述
Rationale: Currently, only 22% of all patients referred to the rheumatologist by primary care are diagnosed with an inflammatory rheumatic disease (IRD). Previous research has shown that structured referral sheets and community-based specialist service improve appropriateness of referrals.
Objective: The aim of this study is to improve the number of effectively referred patients with IRD to the rheumatology outpatient clinic with either use of validated referral pro formas or triage of IRD by specialists in a primary care setting compared to usual care. In addition, the investigators want to provide tools for the general practitioner to recognise IRD and improve early referral of patients with IRD, and a cost-effectiveness analysis will be performed to evaluate the decreasing effect on health-care cost.
Study design: Cluster randomized trial with randomization of general practitioner clinics.
Study population: Primary care patients of 18 years or older who are suspected of an IRD and considered by a GP for referral to a rheumatologist.
Intervention: One group of GPs will use a standardized referral strategy for IRD, another group will consist of triage by a rheumatologist in the local primary care clinic, the third group is usual care.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Screening
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •A primary care patient who is referred by the GP to the rheumatology outpatient clinic
- •Subject must be able to understand and communicate with the rheumatologist
- •Participant must give a written signed and dated informed consent before enrolment.
排除标准
- •Limited understanding of the Dutch language.
- •Legally incapable or vulnerable subject as described in the Medical Research with Human Subjects Act (WMO).
结局指标
主要结局
Percentage of appropriate referred patients
时间窗: 12 months
Percentage of appropriate referred patients as proportion of all patients referred to the rheumatologist by the general practitioner (GP). Appropriate referred defined as patient diagnosed with an inflammatory rheumatic disease (IRD) as assessed by a rheumatologist, with an IRD as final diagnosis.
次要结局
- iMTA Medical Consumption Questionnaire(12 months)
- Health-care costs(12 months)
- EuroQoL Health questionnaire(12 months)
- iMTA Productivity Cost Questionnaire(12 months)