Effects of 'NHGDoc' on Quality of Care

Heart Failure Clinical Trial

— NHGDoc  

Official title:

Effects of the Computerized Decision Support System 'NHGDoc' on Quality of Care: a Cluster Randomized Controlled Trial

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01773057
• Other study ID #: NHGDoc 2012
• Status: Completed
• Phase: N/A
• First received: November 22, 2012
• Last updated: April 11, 2018
• Start date: April 2013
• Est. completion date: September 2017

Study information

• Verified date: October 2016
• Source: Radboud University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to determine whether the computerized decision support system 'NHGDoc' is effective in improving quality of primary care in terms of processes of care (e.g. prescribing behavior of physicians) as well as outcomes of care (e.g. hospital admissions, mortality).

Description:

Computerized decision support systems are regarded as useful tools to improve quality of care, but their effects are still uncertain. In the Netherlands 'NHGDoc' a computerized decision support system supported by the Dutch College of General Practitioners (NHG) is currently being implemented among more than 1.000 general practices in the Netherlands.

The aim of this study is to evaluate the effects of NHGDoc on quality of care. In addition, we want to gain insight into the barriers and facilitators that affect the systems' impact.

A cluster randomized controlled trial will be conducted among 120 general practices in the Netherlands. Eligible practices will be randomized to receive either the regular NHGDoc modules (control arm) or the regular modules and an additional module on heart failure (intervention arm). The effect evaluation will focus on processes of care (e.g. prescription behavior) as well as on patient outcomes (e.g. hospital admissions, mortality). Additionally, a process evaluation will be conducted, which includes a focus group study and a survey among participating healthcare providers to evaluate the perceived barriers and facilitators to using 'NHGDoc'.

Results of this study will provide insight in the ability of computerized decision support systems and in particular 'NHGDoc' to improve quality of primary care. Whereas the trial focuses on a specific NHGDoc domain - heart failure - we believe our conclusions are relevant to other primary care areas as well, particularly as this study also explores the factors that contribute to the systems' effectiveness.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 120
• Est. completion date: September 2017
• Est. primary completion date: May 2017
• Accepts healthy volunteers: No
• Gender: All
• Age group: N/A and older

Eligibility

Inclusion Criteria:

• General practices should use the information system MicroHIS X or Promedico ASP

• NHGDoc should be available in the general practices

Exclusion Criteria:

• General practices that do not meet the inclusion criteria

Related Conditions & MeSH terms

• Heart Failure

Intervention

Other:
• NHGDoc domain Heart Failure
Healthcare providers receive patient specific alerts in terms of diagnosing and treatment of patients with heart failure

Locations

Country	Name	City	State
Netherlands	Radboud University Nijmegen Medical Centre, IQ healthcare	Nijmegen

Sponsors (2)

Lead Sponsor	Collaborator
Radboud University	Netherlands: Ministry of Health, Welfare and Sports

Country where clinical trial is conducted

Netherlands, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Prescribing of ACE-inhibitors/Angiotensin II	Percentage of patients with heart failure that is prescribed ACE-inhibitors/Angiotensin II	One year
Primary	Prescribing of beta blockers	Percentage of heart failure patients that is prescribed beta blockers	One year
Primary	Prescribing of diuretics	Percentage of heart failure patients that is prescribed diuretics	One year
Secondary	Hospital admissions	Number of hospital admissions of patients with heart failure	One year
Secondary	All cause mortality	Number of patients with heart failure that die within the hospital	One year