Implementing Online Patient-Provider Communication Into Clinical Practice

Cancer Clinical Trial

— OPPC  

Official title:

Implementing Online Patient-Provider Communication Into Clinical Practice: Implementation Research

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00971139
• Other study ID #: RCN191008/V50
• Status: Completed
• Phase: N/A
• First received: September 1, 2009
• Last updated: November 2, 2015
• Start date: November 2009
• Est. completion date: December 2013

Study information

• Verified date: November 2015
• Source: Oslo University Hospital
• Contact: n/a
• Is FDA regulated: No
• Health authority: Norway:National Committee for Medical and Health Research Ethics
• Study type: Interventional

Clinical Trial Summary

This interdisciplinary, international collaboration study, including the the Norwegian Health Economy Administration (HELFO) will evaluate the effectiveness and real-world implementation of an online patient-provider communication (OPPC) service into rout ine practice. In Phase I we will identify patients and care providers requirements and organizational contexts, and use participatory design methods to adapt the OPPC service to users needs and the context of clinical practice. In Phase II we will offer study participants access to the OPPC service to understand implementation issues. In addition, we will conduct a pilot randomized clinical trial (usual care; OPPC) with 40 patients in each group that will be followed over 6 months.

Description:

A rapidly growing research literature documents the importance of Health IT to improve communication between health care providers and their patients. Patient Internet portals and online patient-provider communication (OPPC) allow patients to stay connected with their care providers between clinical encounters, get help and advice for their symptoms and problems from home, better understand and manage their illness, and become more engaged in their care. Through better patient-provider partnerships and communication independent of face-to-face visits, health problems and side-effects of treatment can be more easily detected, prevented, and treated more quickly.

Therefore, the overall goal of this international collaboration study is to implement and evaluate the effects and use of a primarily nurse-administered OPPC service, including access to advice from physicians, dietitians and social counselors, as part of regular patient care; and using methods consistent with effectiveness research to bridge the gap between research evidence and translation into routine practice.

The specific aims of this study are twofold:

In Phase I the investigators will refine and implement an Internet-based OPPC service where patients can ask questions and receive advice and support from care providers and social counselors. The investigators will use participatory design methods to adapt an OPPC service to patients' needs; care providers' requirements; and the workflow and organizational and technical infrastructure of clinical practice by answering the following research questions:

What are the predisposing, enabling and reinforcing factors related to successful adoption, implementation and maintenance of the OPPC service such as: potential barriers to successful implementation; workflow adjustments, support and resources needed to implement and maintain the OPPC in daily clinical practice?

In Phase II we will offer study participants access to the OPPC service to understand implementation issues. In addition, we will conduct a pilot randomized clinical trial (usual care; OPPC) with 40 patients in each group that will be followed over 6 months to evaluate:

1. participation rate and OPPC use;

2. characteristics of high/low volume users, patient-caregiver communication and use patterns;

3. perceived usefulness and ease of use and

4. impacts on organizational change and interdisciplinary collaboration.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 199
• Est. completion date: December 2013
• Est. primary completion date: May 2013
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• 18 years of age.

• Able to read/speak Norwegian and have Internet with secure access (BankID) at home.

Exclusion Criteria:

• Excluded are patients who have brain metastasis and patients with cerebral affection caused by the disease (e.g., encephalopathy) as this may affect their abilities to reliably report their symptoms.

• Excluded are also patients who receive a liver transplant indicated by cancer coli, as they participate in another study.

Study Design

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Supportive Care

Related Conditions & MeSH terms

• Cancer
• Diabetes
• Injury of Liver

Intervention

Behavioral:
• Access to an OPPC service
Access to an Internet-based messaging system where patients can ask questions and receive advice and support from care providers at the hospital and social counsellors

Locations

Country	Name	City	State
Norway	Oslo University Hospital - Rikshospitalet	Oslo

Sponsors (2)

Lead Sponsor	Collaborator
Oslo University Hospital	The Research Council of Norway

Country where clinical trial is conducted

Norway, 

References & Publications (4)

Ruland CM, Borosund E, Varsi C. User requirements for a practice-integrated nurse-administered online communication service for cancer patients. Stud Health Technol Inform. 2009;146:221-5. — View Citation

Varsi C, Gammon D, Wibe T, Ruland CM. Patients' reported reasons for non-use of an internet-based patient-provider communication service: qualitative interview study. J Med Internet Res. 2013 Nov 11;15(11):e246. doi: 10.2196/jmir.2683. — View Citation

Wibe T, Ekstedt M, Hellesø R, Varsi C, Ruland C. "You are not at all bothersome" - nurses' online communication with testicular cancer patients. NI 2012 (2012). 2012 Jun 23;2012:453. eCollection 2012. — View Citation

Wibe T, Hellesø R, Varsi C, Ruland C, Ekstedt M. How does an online patient-nurse communication service meet the information needs of men with recently diagnosed testicular cancer? ISRN Nurs. 2012;2012:260975. doi: 10.5402/2012/260975. Epub 2012 Dec 4. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Impacts of the OPPC service on organizational processes/organizational change such as care processes		End of study at 6 (8) months after last included patient	No
Secondary	Participation rate and OPPC use, perceived usefulness and ease of use		End of study at 6 (8) months after last included patient	No
Secondary	Characteristics of high/low volume users, patient-caregiver communication and use patterns		End of study at 6 (8) months after last included patient	No