Nurse vs General Practitioner Care for Patients Requesting Same Day Consultations in Primary Care

Acute Disease Clinical Trial

Official title:

Effectiveness of an Intervention in Primary Care: Randomized Controlled Trial Comparing Care for Patients Requesting Same Day Consultations by Nurse Practitioner vs General Practitioners

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT00461201
• Other study ID #: PI060715
• Status: Not yet recruiting
• Phase: N/A
• First received: April 16, 2007
• Last updated: April 16, 2007
• Start date: January 2009

Study information

• Verified date: April 2007
• Source: Catalan Institute of Health
• Contact: Begoña Iglesias, Physician
• Phone: 0034938931216
• Email: biglesias[@]ambitcp.catsalut.net
• Is FDA regulated: No
• Health authority: Spain: Ministry of Health
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to compare the effectiveness of nursing care in relation to usual medical care in adult patients who demand to be visited the same day in Primary Care Teams in Catalonia, as it is suggested in other countries.

Description:

The primary care demand is rapidly growing and the family physicians feel overflowed by the demand and their capacity to solve things is limited by lack of time. Many organizational interventions have been planned to solve this problem. One of these is to imply the nurse professional to solve and control health problems that traditionally were the doctor’s job. So, to demonstrate the nursing care is as effective as the medical care, we will compare, among both collectives, the ‘quality’ of care received by patients who ask an appointment for the same day.

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 1640
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 15 Years and older

Eligibility

Inclusion Criteria:

• patients requesting same day consultations in primary care

• assigned to the practice

Exclusion Criteria:

• do not want to participate

• difficulties to follow-up

• serious illness that makes the intervention impossible

• home visits

Study Design

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Health Services Research

Related Conditions & MeSH terms

• Acute Disease
• Ambulatory Care
• Family Practice
• Nursing Care

Intervention

Procedure:
• Nurse practitioner care of patients

Locations

Country	Name	City	State
n/a

Sponsors (4)

Lead Sponsor	Collaborator
Catalan Institute of Health	Carlos III Health Institute, Jordi Gol i Gurina Foundation, Netherlands: Ministry of Health, Welfare and Sports

References & Publications (7)

Effectiveness of health checks conducted by nurses in primary care: final results of the OXCHECK study. Imperial Cancer Research Fund OXCHECK Study Group. BMJ. 1995 Apr 29;310(6987):1099-104. — View Citation

Horrocks S, Anderson E, Salisbury C. Systematic review of whether nurse practitioners working in primary care can provide equivalent care to doctors. BMJ. 2002 Apr 6;324(7341):819-23. Review. — View Citation

Kinnersley P, Anderson E, Parry K, Clement J, Archard L, Turton P, Stainthorpe A, Fraser A, Butler CC, Rogers C. Randomised controlled trial of nurse practitioner versus general practitioner care for patients requesting "same day" consultations in primary care. BMJ. 2000 Apr 15;320(7241):1043-8. — View Citation

Mundinger MO, Kane RL, Lenz ER, Totten AM, Tsai WY, Cleary PD, Friedewald WT, Siu AL, Shelanski ML. Primary care outcomes in patients treated by nurse practitioners or physicians: a randomized trial. JAMA. 2000 Jan 5;283(1):59-68. — View Citation

Shum C, Humphreys A, Wheeler D, Cochrane MA, Skoda S, Clement S. Nurse management of patients with minor illnesses in general practice: multicentre, randomised controlled trial. BMJ. 2000 Apr 15;320(7241):1038-43. — View Citation

Venning P, Durie A, Roland M, Roberts C, Leese B. Randomised controlled trial comparing cost effectiveness of general practitioners and nurse practitioners in primary care. BMJ. 2000 Apr 15;320(7241):1048-53. — View Citation

Zwarenstein M, Bryant W. Interventions to promote collaboration between nurses and doctors. Cochrane Database Syst Rev. 2000;(2):CD000072. Review. Update in: Cochrane Database Syst Rev. 2009;(3):CD000072. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Description of the capacity of resolution of the nurse:
Primary	To determine if there are differences in the proportion of patients that make a second appointment for the same reason in the next 2 weeks, comparing the two groups.
Primary	To determine if there are differences in the resolution of symptoms in 2 weeks after the visit comparing the two groups.
Primary	To determine if there are differences in the proportion of admission to hospital or to emergency room the next 2 weeks comparing the two groups.
Primary	To determine if there are differences in the satisfaction and resolution of the worries about the users state of health in 2 weeks after the visit comparing the two groups.
Primary	To determine if there are differences comparing the two groups in the perceived status of health, perception of the information, received attention, resource utilization and future intention to consult again with the same professional.
Secondary	Description of the clinical demands of the users and their demographic characteristics.
Secondary	To identify if there is a type of user in which the effectiveness of the intervention is higher.
Secondary	To determine the proportion of users visited by the nurse not having to be visited by the doctor afterwards for that reason.