Effect of a Coordinated Primary-care-Based MDT-model on the Treatment of Hard-to-heal Ulcers; a Randomized Clinically Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- 入组人数
- 80
- 试验地点
- 1
- 主要终点
- Ulcer healing
研究概览
简要总结
The TSS project is a study of the effects of treating hard-to-heal ulcers in a multidisciplinary cross sectional team, meaning that nurse and doctor from a hospital based wound healing clinic and wound care nurse from the primary care sector treat the patient in collaboration rather than the current form where care in municipalities and hospital setting, communicate but treat the patient on their own. The study is designed as a randomized study, meaning that individuals with hard-to-heal ulcers are randomly designated to standard care or the multidis-ciplinary team. We measure several aspects of the new format, but the main outcome com-pared between the two groups (standard care and multidisciplinary care) is number of ulcers healed.
Participants are followed for a year after inclusion in the study, and have 6 fixed visits in the clinic, with the possibility of more visits if necessary.
There is no "new" medicine, surgery or other treatments planned in the study, but the multi-disciplinary team can offer and implement any treatment deemed appropriate for the individ-ual that is allocated to the multidisciplinary team, of course the individual has the opportunity to decline any treatment offered by the team. The control group, i.e. individuals allocated to standard care, will receive the treatment that is normally available to individuals with hard-to-heal ulcers treated in the municipality, including referral to hospital based treatments.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 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
- •Patients aged 18 years or above
- •Hard-to-heal ulcer(s)
- •Able to understand written and oral information
- •Ability to follow planned visits and treatment
- •Able to provide informed consent in Danish and/or English
排除标准
- •Revascularization procedure in the affected limb planned, or undertaken within the 4 weeks prior to screening
- •Toe blood pressure < 35mmHg
- •Infections of the ulcer needing acute or sub-acute (defined as within seven days) surgical treatment
- •Prior major amputations on affected or contralateral leg
- •Current treatment with cytotoxic drugs or with systemically administered glucocorticoids
- •Likely inability to comply with the need for planned visits because of planned activities
- •Participation in another interventional ulcer-healing trial within the 4 weeks prior to screening
- •Prior enrolment in this trial
- •Judgement by the investigator that the patient does not have the capacity to understand the study procedures or provide written informed consent
研究组 & 干预措施
coordinated primary-care-based MDT-model
The proposed intervention consists of an MDT with an orthopedic surgeon (Jonas Askø Andersen) and a wound care nurse from the wound clinical at North Zealand Hospital as well as a wound care nurse from the primary sector. Participants who are randomized to intervention is offered treatment in the team as deemed appropriate by the MDT. The participant will be seen in the clinic (in the primary sector) for planned study visits at.
1. Week 1 2. Week 4 3. 3 months 4. 6 months 5. 12 months 6. Extra study visits can be planned as deemed necessary for the individual participant between the above outlined visits Weekly visits in the clinic for bandage changes and standard wound care is planned as deemed relevant by the MDT team for the individual participant. The visits are performed by wound care nurses in the primary sector If any outcomes relevant for the study occurs outside of the planned study visits i.e., ulcer healing, infections or recurrence following healing, the participant is pla
干预措施: coordinated primary-care-based MDT-model (Other)
Standard Care
Participants randomized to control are not invited to be seen by the MDT team but are attended by the wound care nurse from the primary sector as part of the standard treatment offered to individuals with ulcers in the municipality. Apart from planned visits at 3, 6 and 12 months, the frequency and number of visits in the study period is performed as deemed appropriate by the wound care nurses from the primary sector. If any outcomes relevant for the study occurs outside of the planned study visits i.e., ulcer healing, infections or recurrence following healing date of event is noted.
干预措施: Standard Care (in control arm) (Other)
结局指标
主要结局
Ulcer healing
时间窗: Ulcer healing at 12 months
Number of individuals that achieve healing of their hard-to-heal ulcer(s), compared between two arms
次要结局
- Time to ulcer healing(12 moths)
- Ulcer recurrence(12 months)
- Infections(12 months)
- Amputations(12 months)
- Visits(12 months)
- Hospital admissions(12 months)
- Patient related outcomes(12 months)
- Cost effectiveness(12 months)
- RE-AIM(12 months)
研究者
Jonas Askø Andersen
MD Phd Clin Assoc Prof
Nordsjaellands Hospital