Activating GENeral practitioners dialogue with patients on their Agenda (MultiCare AGENDA) study protocol for a cluster randomized controlled trial
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Activating GENeral practitioners dialogue with patients on their Agenda (MultiCare AGENDA) study protocol for a cluster randomized controlled trial. / Altiner, Attila; Schäfer, Ingmar; Mellert, Christine; Löffler, Christin; Mortsiefer, Achim; Ernst, Annette; Stolzenbach, Carl-Otto; Wiese, Birgitt; Scherer, Martin; Bussche van den, Hendrik; Kaduszkiewicz, Hanna; Bussche van den, Hendrik.
In: BMC FAM PRACT, Vol. 13, 01.01.2012, p. 118.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Activating GENeral practitioners dialogue with patients on their Agenda (MultiCare AGENDA) study protocol for a cluster randomized controlled trial
AU - Altiner, Attila
AU - Schäfer, Ingmar
AU - Mellert, Christine
AU - Löffler, Christin
AU - Mortsiefer, Achim
AU - Ernst, Annette
AU - Stolzenbach, Carl-Otto
AU - Wiese, Birgitt
AU - Scherer, Martin
AU - Bussche van den, Hendrik
AU - Kaduszkiewicz, Hanna
AU - Bussche van den, Hendrik
PY - 2012/1/1
Y1 - 2012/1/1
N2 - BACKGROUND: This study investigates the efficacy of a complex multifaceted intervention aiming at increasing the quality of care of GPs for patients with multimorbidity. In its core, the intervention aims at enhancing the doctor-patient-dialogue and identifying the patient's agenda and needs. Also, a medication check is embedded. Our primary hypothesis is that a more patient-centred communication will reduce the number of active pharmaceuticals taken without impairing the patients' quality of life. Secondary hypotheses include a better knowledge of GPs about their patients' medication, a higher patient satisfaction and a more effective and/or efficient health care utilization.METHODS/DESIGN: Multi-center, parallel group, cluster randomized controlled clinical trial in GP surgeries. Inclusion criteria: Patients aged 65-84 years with at least 3 chronic conditions. Intervention: GPs allocated to this group will receive a multifaceted educational intervention on performing a narrative doctor-patient dialogue reflecting treatment targets and priorities of the patient and on performing a narrative patient-centred medication review. During the one year intervention GPs will have a total of three conversations à 30 minutes with the enrolled patients. Control: Care as usual. Follow-up per patient: 14 months after baseline interview. Primary efficacy endpoints: Differences in medication intake and health related quality of life between baseline and follow-up in the intervention compared to the control group. Randomization: Computer-generated by an independent institute. It will be performed successively when patient recruitment in the respective surgery is finished. Blinding: Participants (GPs and patients) will not be blinded to their assignment but will be unaware of the study hypotheses or outcome measures.DISCUSSION: There is growing evidence that the phenomenon of polypharmacy and low quality of drug use is substantially due to mis-communication (or non-communication) in the doctor patient interaction. We assume that the number of pharmaceutical agents taken can be reduced by a communicational intervention and that this will not impair the patients' health-related quality of life. Improving communication is a core issue of future interventions, especially for patients with multimorbidity.TRIAL REGISTRATION: Current Controlled Trials ISRCTN46272088.
AB - BACKGROUND: This study investigates the efficacy of a complex multifaceted intervention aiming at increasing the quality of care of GPs for patients with multimorbidity. In its core, the intervention aims at enhancing the doctor-patient-dialogue and identifying the patient's agenda and needs. Also, a medication check is embedded. Our primary hypothesis is that a more patient-centred communication will reduce the number of active pharmaceuticals taken without impairing the patients' quality of life. Secondary hypotheses include a better knowledge of GPs about their patients' medication, a higher patient satisfaction and a more effective and/or efficient health care utilization.METHODS/DESIGN: Multi-center, parallel group, cluster randomized controlled clinical trial in GP surgeries. Inclusion criteria: Patients aged 65-84 years with at least 3 chronic conditions. Intervention: GPs allocated to this group will receive a multifaceted educational intervention on performing a narrative doctor-patient dialogue reflecting treatment targets and priorities of the patient and on performing a narrative patient-centred medication review. During the one year intervention GPs will have a total of three conversations à 30 minutes with the enrolled patients. Control: Care as usual. Follow-up per patient: 14 months after baseline interview. Primary efficacy endpoints: Differences in medication intake and health related quality of life between baseline and follow-up in the intervention compared to the control group. Randomization: Computer-generated by an independent institute. It will be performed successively when patient recruitment in the respective surgery is finished. Blinding: Participants (GPs and patients) will not be blinded to their assignment but will be unaware of the study hypotheses or outcome measures.DISCUSSION: There is growing evidence that the phenomenon of polypharmacy and low quality of drug use is substantially due to mis-communication (or non-communication) in the doctor patient interaction. We assume that the number of pharmaceutical agents taken can be reduced by a communicational intervention and that this will not impair the patients' health-related quality of life. Improving communication is a core issue of future interventions, especially for patients with multimorbidity.TRIAL REGISTRATION: Current Controlled Trials ISRCTN46272088.
KW - Aged
KW - Aged, 80 and over
KW - Chronic Disease
KW - Communication
KW - Comorbidity
KW - Follow-Up Studies
KW - General Practice
KW - Germany
KW - Humans
KW - Medication Reconciliation
KW - Outcome Assessment (Health Care)
KW - Patient Care Planning
KW - Patient Participation
KW - Patient Satisfaction
KW - Patient-Centered Care
KW - Physician-Patient Relations
KW - Polypharmacy
U2 - 10.1186/1471-2296-13-118
DO - 10.1186/1471-2296-13-118
M3 - SCORING: Journal article
C2 - 23234237
VL - 13
SP - 118
JO - BMC PRIM CARE
JF - BMC PRIM CARE
SN - 1471-2296
ER -