Chronic Disease
Conditions
Keywords
Health Services Research, Chronic Care, Outreach Visits, Primary care, chronic disease management
Brief summary
The aim of this project is to motivate and support general practice clinics in implementing the visions and recommendations presented in two of the disease specific programmes for chronic care management (for chronic obstructive lung disease and Type 2 diabetes). These programmes describe evidence based treatment and division of tasks between the municipalities, the hospitals and general practice. The Facilitator Project is funded by The Danish Ministry of Interior and Health.
Detailed description
In a cluster randomized trial the investigators will explore the efficacy of up to three outreach visits by specially trained GPs. Efficacy data are obtained by means of questionnaires at regional databases.
Interventions
BEHAVIORALOutreach visits
The 16 facilitators in the project attend an educational programme designed to provide them with the necessary skills and tools for the task. The facilitators visit general practice clinics from March 2011 until the end of 2012. Each clinic is offered three visits. The facilitator is to act as a change agent who motivates and helps the clinic team in the process of defining common goals, and choosing the appropriate means for achieving them.
Sponsors
Region Capital Denmark
Research Unit Of General Practice, Copenhagen
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
30 Years to 70 Years
Healthy volunteers
Yes
Inclusion criteria
General Practices working in the capital region in Denmark
Exclusion criteria
General Practices where the facilitator works.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change from baseline at 12 month in Annual systematic chronic disease follow up consultations | Month 4, 3, 2 before baseline and month 13,14,15 after baseline (after intervention) | Change in annual systematic chronic disease controls per person affiliated with a primary care at a period at baseline and at 12 month. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| ICPC diagnosis coding | 12 months | Self reports regarding the use of ICPC diagnosis coding for Type 2 Diabetes and Chronic Obstructive Pulmonary Disease. |
| Sentinel Data Capture | 12 months | Application for the electronic Sentinel Data Capture module for overview of patients with chronic diseases. |
| Stratification | 12 months | The self reported use of stratification as part of primary care management of patients with chronic diseases |
| Change from baseline and at 12 month in practices with low performance on annual systematic chronic disease follow up consultations. | Month 4, 3, 2 before baseline and month 13,14,15 after baseline (after intervention) | Reduction in the number of practices with less than 1% annual systematic chronic disease follow up consultations. |
Countries
Denmark
Outcome results
None listed