tailieunhanh - báo cáo khoa học: " Improvement of primary care for patients with chronic heart failure: A study protocol for a cluster randomised trial comparing two strategies"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Improvement of primary care for patients with chronic heart failure: A study protocol for a cluster randomised trial comparing two strategies | van Lieshout et al. Implementation Science 2011 6 28 http content 6 1 28 IMPLEMENTATION SCIENCE Implementation Science STUDY PROTOCOL Open Access Improvement of primary care for patients with chronic heart failure A study protocol for a cluster randomised trial comparing two strategies Jan van Lieshout1 Betty Steenkamer2 Marjan Knippenberg1 and Michel Wensing1 Abstract Background Many patients with chronic heart failure CHF a common condition with high morbidity and mortality rates receive treatment in primary care. To improve the management of CHF in primary care we developed an implementation programme comprised of educational and organisational components with support by a practice visitor and focus both on drug treatment and lifestyle advice and on organisation of care within the practice and collaboration with other healthcare providers. Tailoring has been shown to improve the success of implementation programmes but little is known about what would be best methods for tailoring specifically with respect to CHF in primary care. Methods design We describe the study protocol of a cluster randomised controlled trial to examine the effectiveness of tailoring a CHF implementation programme to general practices compared to a standardised way of delivering a programme. The study population will consist of 60 general practitioners GPs and the CHF patients they include. GPs are randomised in blocks of four stratified according to practice size. With a tailored implementation programme GPs prioritise the issues that will form the bases of the support for the practice visits. These may comprise several issues both educational and organizational. The primary outcome measures are patient s experience of receiving structured primary care for CHF PACIC a questionnaire related to the Chronic Care Model patients health-related utilities EQ-5D and drugs prescriptions using the guideline adherence index. Patients being clustered in practices .

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