Testing the SNOWDROP Intervention: Using a Clinical Decision Support System and Patient Portal for Falls Prevention Among Older Patients in Primary Care

Not Applicable

Completed

• Conditions: Fall Injury; Fall Patients; Fall; Accidental Fall; Deprescribing
• Interventions: Device: CDSS; Device: Patient Portal

• Registration Number: NCT05611008
• Lead Sponsor: University of Amsterdam

Brief Summary

Falls are a leading cause of injuries among older patients. Medication use is a major risk factor for falls. Because we lack tools to assess individualized risks, general practitioners (GPs) struggle with fall-related medication management for older patients. Furthermore, these older patients are often not properly equipped to engage in the joint management of their medication. A Clinical Decision Support System (CDSS) for GPs and a patient portal for older patients may stimulate shared decision making between GPs and older patients when discussing the medication-related fall risk. The CDSS provides the GP with advice on how to alter medication in such a way that the fall risk decreases, and the patient portal helps the older patient to prepare for a consultation and to engage in the joint management of their medication.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2022-10-18
• Study First Submitted QC: 2022-11-03
• Study First Posted: 2022-11-09
• Study Start: 2022-11-21
• Primary Completion: 2023-10-30
• Study Completion: 2023-10-30
• Status Verified: 2024-01
• Last Update Submitted: 2024-01-09
• Last Update Posted: 2024-01-10

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 85

Inclusion Criteria

• Aged 70 years or older
• High fall risk
• Takes at least 1 Fall Risk Increasing Drug (FRID)

Exclusion Criteria

Not provided

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Intervention condition	CDSS	-
Intervention condition	Patient Portal	-

Primary Outcome Measures

Name	Time	Method
Shared decision making	During consultation	This concerns the extent to which shared decision making between patient and GP during the consultation. This will be assessed using the Observer OPTION Multiple Chronic Conditions (OPTION-MCC). Consultation are audiotaped and will be coded on shared decision making using this coding scheme.

Secondary Outcome Measures

Name	Time	Method
Technology Acceptance Model (TAM; patient portal)	At baseline & two weeks after consultation	The Technology Acceptance Model (TAM) measures the adoption of a new technology/system based on user attitudes in relation to the patient portal.
Website Satisfaction Scale (WSS; patient portal)	At baseline & two weeks after consultation	The Website Satisfaction Scale (WSS) measures satisfaction with comprehensibility, satisfaction with attractiveness, and satisfaction with emotional support, in relation to the patient portal.
Patient portal usage	At baseline & two weeks after consultation	Patients are asked if they used the patient portal and which components they used.
Technology Acceptance Model (TAM; CDSS)	After the first consultation (study beginning) and after the last consultation (study completion after +/- 7 months)	The Technology Acceptance Model (TAM) measures the adoption of a new technology/system based on user attitudes in relation to the CDSS to be answered by the GP. This is assessed by measuring Perceived Usefulness, Perceived Ease of Use, and Intention to use.
Netherlands Patient Information Recall Questionnaire (NPIRQ)	Two weeks after consultation	The Netherlands Patient Information Recall Questionnaire consists of open questions measuring patients' recall of what was discussed and decided during the consultation.
Decisional Conflict Scale (DCS)	Two weeks after consultation	The decisional conflict scale measures decisional conflict after the consultation related to five subscales: feeling informed, uncertainty, values clarity, support, and effective decision making.
Beliefs About Medicines Questionnaire (BMQ)	Baseline & two weeks after consultation	The Beliefs about Medicines Questionnaire measures beliefs about the necessity of medication and concerns about medication.
Changes in medication	Baseline & two weeks after the consultation	Changes in prescriptions of the medication as reported in the electronic health record.
Evaluation of the consultation	Immediately after each consultation	Four items to assess the consultation to be answered by the GP. The items assess to what extent the patient was representative, their opinion on the communication during the consultation, the extent to which they are satisfied with any decisions made and the difficulty of the consultation.
The Website Satisfaction Scale (WSS; CDSS)	After the first consultation (study beginning) and after the last consultation (study completion after +/- 7 months)	The Website Satisfaction Scale (WSS) measures satisfaction with comprehensibility, satisfaction with attractiveness, and satisfaction with emotional support, in relation to the CDSS to be answered by the GP.

Trial Locations

Locations (1)

Huisartsenpraktijken; 🇳🇱 Amsterdam, Netherlands