Knee Osteoarthritis Care: A Quality Improvement Intervention in General Practice
Primary Purpose
Knee Osteoarthritis
Status
Completed
Phase
Not Applicable
Locations
Belgium
Study Type
Interventional
Intervention
Academic detailing visit arm
Sponsored by
About this trial
This is an interventional treatment trial for Knee Osteoarthritis focused on measuring intervention, improvement strategy
Eligibility Criteria
Inclusion Criteria:
- active GP setting
- visited by independent medical visitors for academic detailing
Exclusion Criteria:
- not willing to participate
- not visited by independent medical visitors for academic detailing
Sites / Locations
- KU Leuven
Arms of the Study
Arm 1
Arm 2
Arm Type
Other
No Intervention
Arm Label
Academic detailing visit arm
control group
Arm Description
The GPs will receive an academic detailing visit by a medical visitor. GPs will receive information on the conservative evidence-based management of knee osteoarthritis with physiotherapy. The information will be summarized on a flyer for the GPs.
The two case vignettes will also be presented to GP who did not received the intervention.
Outcomes
Primary Outcome Measures
Number of referrals to physical therapy of patients with knee osteoarthritis
2 case vignettes were developed to assess GPs' referral rate
Secondary Outcome Measures
Number of technical investigations ordered by GPs for patients with knee osteoarthritis
2 case vignettes were developed to assess GPs' request of technical investigations
Type of pain medication prescribed by GPs for patients with knee osteoarthritis
2 case vignettes were developed to assess GPs' medication prescriptions
Full Information
NCT ID
NCT03106142
First Posted
October 26, 2016
Last Updated
May 2, 2017
Sponsor
Universitaire Ziekenhuizen KU Leuven
1. Study Identification
Unique Protocol Identification Number
NCT03106142
Brief Title
Knee Osteoarthritis Care: A Quality Improvement Intervention in General Practice
Official Title
Improving Current General Practitioners Care: Feasibility and Effectiveness of a Simple Educational Intervention. Knee Osteoarthritis Care: a Quality Improvement in General Practice
Study Type
Interventional
2. Study Status
Record Verification Date
March 2017
Overall Recruitment Status
Completed
Study Start Date
September 2014 (Actual)
Primary Completion Date
November 2014 (Actual)
Study Completion Date
July 2015 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Universitaire Ziekenhuizen KU Leuven
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
The aim of this study is to improve the referral rates to physiotherapy of patients with knee osteoarthritis. The intervention consists of one academic detailing visit directed to general practitioners (GPs)
Detailed Description
In Belgium, referral rates to physiotherapy of patients with knee osteoarthritis are low. A surveys shows that only 11% of the patients with knee osteoarthritis are referred for physiotherapy in an early stage of the disease process. Referral to physiotherapy is common after arthroplasty for revalidation, but not in early stage of the disease process. The aim of this study is to increase the referral rate for physiotherapy in an early stage of the disease process.
One to three times a year, a large part of Belgian GPs receive an academic detailing visit by an independent medical visitors of Farmaka. Farmaka is a non-profit organization, which is sponsored by the government. Each year, three medical and medication-related themes are developed to provide evidence-based and independent information for primary care management. A visit takes about 20 minutes.
The medical visitors of Farmaka will spend 5 minutes of their standard visit to inform GPs about the evidence-based conservative management of knee osteoarthritis with physiotherapy. The information will focus on the referral of patients with knee osteoarthritis to a physiotherapist in an early stage of the disease. To optimize the effect of the referral to physiotherapists, GPs are asked to specify their prescription by adding a clear therapy description 'exercise therapy with aerobic, muscle strengthening and functional exercises'.
This information will be summarized on a flyer. This flyer will be distributed to the GPs at the end of the academic detailing visit. The flyer gives more extended information about the approach and treatment of knee osteoarthritis. The information and flyer will only be distributed to the intervention group.
For the sample size calculation we want to optimize the referral rate to physiotherapists with 15%.
To detect an absolute difference of 15% in referral rate to physiotherapists we need 100 patients in each group ( with significance level of 5%, 1 on 1 allocation and power of 80%). The control group is composed of GPs, visited by Farmaka, who will not receive the additional information on knee osteoarthritis management.
After 6 months the GPs of the intervention and control group will receive two case vignettes on the management of knee osteoarthritis.
The number of referrals to a physiotherapist of the intervention group and the control group will be compared, as well as the number of specified well-directed prescriptions.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Knee Osteoarthritis
Keywords
intervention, improvement strategy
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Intervention group Control group (usual care)
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
177 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Academic detailing visit arm
Arm Type
Other
Arm Description
The GPs will receive an academic detailing visit by a medical visitor. GPs will receive information on the conservative evidence-based management of knee osteoarthritis with physiotherapy. The information will be summarized on a flyer for the GPs.
Arm Title
control group
Arm Type
No Intervention
Arm Description
The two case vignettes will also be presented to GP who did not received the intervention.
Intervention Type
Procedure
Intervention Name(s)
Academic detailing visit arm
Intervention Description
General Practitioners in the intervention group will receive one academic detailing visit. During this visit the GPs will receive information about the importance of physical therapy in the non-surgical management of knee osteoarthritis. The information will be summarized on an information leaflet for the GP.
Primary Outcome Measure Information:
Title
Number of referrals to physical therapy of patients with knee osteoarthritis
Description
2 case vignettes were developed to assess GPs' referral rate
Time Frame
6 months after intervention
Secondary Outcome Measure Information:
Title
Number of technical investigations ordered by GPs for patients with knee osteoarthritis
Description
2 case vignettes were developed to assess GPs' request of technical investigations
Time Frame
6 months after the intervention
Title
Type of pain medication prescribed by GPs for patients with knee osteoarthritis
Description
2 case vignettes were developed to assess GPs' medication prescriptions
Time Frame
6 months after the intervention
10. Eligibility
Sex
All
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria:
active GP setting
visited by independent medical visitors for academic detailing
Exclusion Criteria:
not willing to participate
not visited by independent medical visitors for academic detailing
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Patrik Vankrunkelsven, Professor
Organizational Affiliation
KU Leuven
Official's Role
Principal Investigator
Facility Information:
Facility Name
KU Leuven
City
Leuven
ZIP/Postal Code
3000
Country
Belgium
12. IPD Sharing Statement
Citations:
PubMed Identifier
12761604
Citation
Habraken H, Janssens I, Soenen K, van Driel M, Lannoy J, Bogaert M. Pilot study on the feasibility and acceptability of academic detailing in general practice. Eur J Clin Pharmacol. 2003 Jul;59(3):253-60. doi: 10.1007/s00228-003-0602-6. Epub 2003 May 22.
Results Reference
background
PubMed Identifier
19468007
Citation
May F, Simpson D, Hart L, Rowett D, Perrier D. Experience with academic detailing services for quality improvement in primary care practice. Qual Saf Health Care. 2009 Jun;18(3):225-31. doi: 10.1136/qshc.2006.021956.
Results Reference
background
Learn more about this trial
Knee Osteoarthritis Care: A Quality Improvement Intervention in General Practice
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