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Open Label Randomized Clinical Trial to Assess the Safety of Teleconsultation

Not Applicable
Recruiting
Conditions
Various Clinical Conditions Commonly Followed up in a Secondary Hospital
Interventions
Other: Face-to-face appointment
Other: Remote consultation (telephone or video consultation mode)
Registration Number
NCT05094180
Lead Sponsor
Consorci Sanitari de l'Alt Penedès i Garraf
Brief Summary

Randomized-controlled trial to assess the safety of remote consultations (both video and teleconsultation) in the follow-up of patients in the hospital setting. A total of 2136 patients will be randomly allocated into one of the three study arms: A) face-to-face consultation (control) B) Remote consultation (telephone or video consultation). Primary outcome will be the frequency of complications of the underlying disease, including adverse reactions to the treatment of the underlying disease.

To be eligible for remote consultation, patients have to have adequate digital literacy at physician discretion, technological capacity to use the video conferencing software, and undergo a type of follow-up that, due to the moderate complexity of the pathology, do not require physical examinations. Patients followed up in more than three departments, those with visual or hearing impairments that may hamper patient-physician communication, and those enrolled in another clinical trial that requires an experimental intervention during the follow-up will be excluded from the study.

Physicians can schedule and cancel appointments at their discretion. At least three visits should be scheduled in the study setting: the baseline visit (i.e., screening visit), intermediate visits (pre-defined by the physician based on the follow-up needed for managing the baseline condition), and the final visit (i.e., either the follow-up visit closest to 12 ± 2 months after enrollment or before in case of discharge or early discontinuation).

The primary objective will be assessed using a non-inferiority analysis of the cumulative incidence of complications of the baseline disease between remote consultation (video and teleconsultation arms) and face-to-face consultation, using a non-inferiority margin of 2%. The analysis will be based on a modified binomial test to assess the non-inferiority of an experimental intervention vs. a control group in a three-arm trial. The primary analysis will be conducted on a per-protocol study sample, which will include all participants who have finished the study and have not been withdrawn because of non-allowed visits using modalities other than scheduled.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
2136
Inclusion Criteria
  • Men and women of any age.
  • Possibility of making consultations by telephone, at the discretion of the investigator, taking into account the severity and complexity of the baseline pathology and the objective of health care.
  • Forecast to carry out follow-up in external consultation.
  • Agreement to be attended through a non-face-to-face system.
  • Ability to connect to the video consultation system.
  • Device compatible with the video consultation system.
  • Possibility of collaborating in the necessary evaluations.
  • Legal capacity to give informed consent.
  • Signature of the informed consent for inclusion of the study.
Exclusion Criteria
  • Need to carry out physical examinations, visualize the patient in person or perform techniques that involve face-to-face visits.
  • Need for face-to-face consultation due patient's clinical situation.
  • Follow-up by more than three medical specialists.
  • Visual, hearing or functional impairments that may hamper patient-physician communication.
  • Patients enrolled in another clinical trial that requires an experimental intervention during the follow-up.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Face-to-face consultationFace-to-face appointment-
Remote consultation (telephone or video consultation mode)Remote consultation (telephone or video consultation mode)-
Primary Outcome Measures
NameTimeMethod
Complications of the underlying disease12 months

Frequency of complications of the underlying disease, including adverse reactions to the treatment of the underlying disease

Secondary Outcome Measures
NameTimeMethod
Number of unscheduled medical contacts12 months

Count of unscheduled medical contacts (phone calls, unscheduled visits, ER visits, and admissions) registered in the hospital information system

Healthcare expenditure12 months

Estimated healthcare expenditure associated with each of the three interventions

Severe complications of the baseline disease12 months

Frequency of severe complications of the underlying disease.

Treatment Serious Adverse Event12 months

Frequency of Serious Adverse Events related to the underlying disease's treatment

Avoidable hospitalizations12 months

Total and avoidable hospitalizations, secondary to ambulatory care sensitive conditions

Care process indicators12 months

Number of consultations made in a format different from the one initially foreseen (face-to-face, telephone consultation or video consultation) Number of empty consultations (the patient does not attend) Number of patients who interrupt their outpatient follow-up Number of prescriptions and type of prescription

Usability of video consultation system12 months

Usability of video consultation system, measured by using the Computer System Usability Questionnaire

Satisfaction of users (health professionals and patients) with the process of clinical care12 months

Degree of satisfaction of users (health professionals and patients) with the process of clinical care, measured by using the satisfaction questionary of the Pla d'enquestes de satisfacció del CatSalut

Trial Locations

Locations (3)

Hospital Residència Sant Camil

🇪🇸

Sant Pere De Ribes, Barcelona, Spain

Centre de Rehabilitació

🇪🇸

Vilanova I La Geltrú, Barcelona, Spain

Hospital Comarcal de l'Alt Penedès

🇪🇸

Vilafranca Del Penedès, Barcelona, Spain

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