Palliative Care
Conditions
Brief summary
The goal of this clinical trial is to learn if a digital health app called DINKNESH is effective for palliative care identification compared to traditional paper-based assessment tools. It will also look at the factors that help or hinder the use of this app in primary care settings. The main questions it aims to answer are: Does the DINKNESH app improve palliative care assessments compared to paper forms? What are the main barriers and facilitators for Health Extension Workers when using the app in their daily work? We will compare the DINKNESH app to standard paper-based tools to see if digital tools improve clinical assessment and implementation. Participants will: Be assessed for palliative care needs using either the DINKNESH mobile app or standard paper forms. Receive routine follow-up care as determined by their health provider. (For health workers): Participate in interviews or surveys to discuss their experience using the assigned assessment tool.
Interventions
OTHERDINKNESH App
A mobile-based digital health application designed to support Family Health Teams in the systematic identification and assessment of patients with palliative care needs. The application digitizes validated clinical tools, including the Supportive and Palliative Care Indicators Tool (SPICT), the Eastern Cooperative Oncology Group (ECOG) performance status, and the Integrated Palliative care Outcome Scale (IPOS) along with reference materials
OTHERPaper based tool
A paper-based clinical assessment protocol designed to support Family Health Teams in the systematic identification and assessment of patients with palliative care needs. It incorporates the same validated clinical tools used in the intervention arm, including the Supportive and Palliative Care Indicators Tool (SPICT), the Eastern Cooperative Oncology Group (ECOG) performance status, and the Integrated Palliative care Outcome Scale (IPOS), administered manually during routine home visits without the use of a digital application and reference material.
Sponsors
Addis Ababa University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* For patients(Quantitative Part): * Adults aged 18 years or older * Currently diagnosed with one or more chronic conditions and receiving home-based follow-up care from a participating Family Health Team within the catchment area of a selected study cluster * Willing to provide verbal informed consent, or has a primary caregiver willing to provide proxy consent * For healthcare workers: * Staff members of the Family Health Team at the selected clusters * Involved in delivering or supervising palliative care services during the study period * For the qualitative part: Participated in the DINKNESH App implementation process and is willing to participate in a Focus Group Discussion (FGD)
Exclusion criteria
* For patients * Patients whose clinical condition prevents both self-participation and proxy participation in the assessment process * Patients already formally identified and referred for palliative care prior to the study period * For healthcare workers: * Staff members planning to be absent for more than 1 day during the six-week active study period * Healthworkers not present during the training session
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rate of identification of patients with palliative care needs. | 6 weeks | The primary outcome is the rate of palliative care identifications, calculated as the number of individuals identified as requiring palliative care divided by the total number of chronic patient visit conducted by the Family Health Teams during the study period. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Qualitative assessment of implementation barriers and enablers. | 6 weeks | Evaluation of implementation determinants (barriers and facilitators) through focus group discussions with health extension workers |
Countries
Ethiopia
Outcome results
None listed