Topic: Primary Care Research Network for England
Conditions
Interventions
This is a cluster randomised trial. Clustering is at the level of the GP practice. The aim is to recruit 32 practices across England and Scotland. This is a two-arm trial with practices being randomis
one by usual nurse and one by usual doctor every 6 months, instead of separate clinics for each condition. The 3 'D's are:
3.1. Dimensions of health - focus on quality of life issues a
Sponsors
University of Bristol (UK)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Current inclusion criteria as of 28/04/2015: 1. Male and female, aged 18 and over 2. Three or more long term conditions from the following list of conditions: 2.1. Cardiovascular disease (CVD) or chronic kidney disease (CVD) including heart disease, hypertension, heart failure, peripheral arterial disease, chronic kidney disease stage 3 to 5 2.2. Stroke 2.3. Diabetes 2.4. COPD or asthma 2.5. Epilepsy 2.6. Atrial fibrillation 2.7. Severe mental health problems (eg. Schizophrenia, psychotic illnesses) 2.8. Depression 2.9. Dementia 2.10. Learning disability 2.11. Rheumatoid arthritis Previous inclusion criteria: 1. Male and female, aged 18 and over 2. Three or more long term conditions from the following list of conditions: 2.1. CVD: coronary heart disease, hypertension, heart failure, peripheral arterial disease 2.2. Stroke 2.3. Diabetes 2.4. Chronic kidney disease 2.5. COPD or asthma 2.6. Epilepsy 2.7. Atrial fibrillation 2.8. Severe mental health problems (e.g., schizophrenia, psychotic illnesses) 2.9. Depression 2.10. Dementia 2.11. Learning disability 2.12. Osteoporosis 2.13. Rheumatoid arthritis
Exclusion criteria
Exclusion criteria: Current exclusion criteria as of 28/04/2015: 1. Life expectancy of less than 12 months 2. Serious suicidal risk 3. Known to be leaving practice within 12 months 4. Cannot complete questionnaires in English (themselves or with the help of carers) 5. Adults lacking capacity to consent (Scotland only) Previous exclusion criteria: 1. Life expectancy of less than 12 months 2. Serious suicidal risk 3. Known to be leaving practice within 12 months 4. Cannot complete questionnaires in English (themselves or with the help of carers)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Health related quality of life, measured using EQ-5D; Timepoint(s): 12 months Updated 19/01/2016: 15 months | — |
Secondary
| Measure | Time frame |
|---|---|
| Current secondary outcome measures as of 02/02/2017: 1. Illness burden, measured using the Bayliss measure of illness burden in multimorbidity; Timepoint(s): 9 and 15 months 2. Consultation empathy, measured using the CARE measure. Timepoint(s): GP consultations, 9 and 15 months; nurse consultations, 15 months only 3. Carer experience, measured using the Carer Experience Scale; Timepoint(s): 9 and 15 months 4. Hospital admission and outpatient rates, measured using patient records and questionnaire; Timepoint: 15 months 5. Anxiety and depression, measured using the Hospital Anxiety Depression Scale (HADS); Timepoint(s): 9 and 15 months 6. Management of LTCs, measured using PACIC; Timepoint(s): 9 and 15 months 7. Medication adherence, measured using the Morisky Medication Adherence Scale; Timepoint(s): 9 and 15 months 8. Number of drugs prescribed, measured using patient records; Timepoint: 15 months 9. Quality of disease management, measured using the Quality Outcomes Framework indicators; Timepoint(s): 15 months 10. Self-rated health, measured using single question item; Timepoint(s): 9 and 15 months 11. Treatment burden, measured using the Multimorbidity Treatment Burden Questionnaire; Timepoint(s): 9 and 15 months 12. Use of health services, measured using patient records and questionnaire; Timepoint: 15 months 13. Overall satisfaction, measured using single question item; Timepoint 9 and 15 months 14. Health related quality of life, measured using EQ-5D; Timepoint 9 months 15. Care which is joined up and related to patients’ priorities, measured using two questions from the LTC6 questionnaire; Timepoint(s) 9 and 15 months 16. Number of high risk prescribing indicators, measured using POEMS study indicators; Tim | — |
Countries
United Kingdom
Outcome results
None listed