Effectiveness and cost-effectiveness of a multi-component strategy to implement a clinical practice guide and improve health outcomes in people with lupus (Q3142230)

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Project Q3142230 in Spain
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English
Effectiveness and cost-effectiveness of a multi-component strategy to implement a clinical practice guide and improve health outcomes in people with lupus
Project Q3142230 in Spain

    Statements

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    32,300.0 Euro
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    38,000.0 Euro
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    85.0 percent
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    1 January 2016
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    30 September 2020
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    FUNDACION CANARIA DE INVESTIGACION SANITARIA (FUNCANIS)
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    28°28'10.74"N, 16°15'14.72"W
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    38038
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    Objetivo principal: Evaluar la efectividad y coste-efectividad de una estrategia de transferencia de conocimiento multicomponente para implementar una guía de práctica clínica (GPC) para el lupus eritematoso sistémico (LES). Metodología para objetivo principal: Diseño: ensayo clínico abierto, multicéntrico y aleatorizado por clusters (hospital). Ámbito: 4 hospitales de referencia del Servicio Canario de Salud. Población: pacientes con LES y médicos reumatólogos e internistas responsables de su cuidado. Muestra: 418 pacientes y 20 profesionales (5 por hospital). Aleatorización: por hospital (2 hospitales a G.control y 2 a intervención). Intervención de implementación multicomponente formada por: componente educativo, un SADC desarrollado a partir de la GPC-LES y un sistema automatizado de feedback integrado en la historia clínica electrónica. Medida principal: actividad del LES autopercibida por el paciente (escala SLAQ) y adherencia a las recomendaciones del SADC. Variables secundarias: calidad de vida relacionada con la salud (EQ-5D-5L); percepción del paciente sobre su participación en la toma de decisiones (SDM-Q-9), adherencia a las recomendaciones del SADC, utilización de recursos. Análisis: modelo lineal generalizado para las variables principales y secundarias, ajustados según gravedad del paciente y el adherencia a las recomendaciones del SADC. Todos los análisis se ejecutarán por intención a tratar. Se aplicará un modelo de ecuaciones estructurales (programa EQS) para contrastar un modelo de relaciones causales entre características sociodemográficas y clínicas del paciente, intervención, variables de proceso, auto-eficacia del paciente en el manejo de su salud y resultados de salud. (Spanish)
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    Main objective: Evaluate the effectiveness and cost-effectiveness of a multicomponent knowledge transfer strategy to implement a clinical practice guide (CPG) for systemic lupus erythematosus (SLE). Methodology for main objective: Design: open, multicenter and randomised clinical trial by clusters (hospital). Scope: 4 reference hospitals of the Canary Health Service. Population: patients with SLE and rheumatologists and internists responsible for their care. Sample: 418 patients and 20 professionals (5 per hospital). Randomisation: per hospital (2 hospitals to G.control and 2 to intervention). Multi-component implementation intervention consisting of: educational component, a SADC developed from GPC-LES and an automated feedback system integrated into electronic medical history. Main measure: patient self-perceived SLE activity (Slaq scale) and adherence to SADC recommendations. Secondary variables: health-related quality of life (EQ-5D-5L); patient perception of participation in decision-making (SDM-Q-9), adherence to SADC recommendations, use of resources. Analysis: generalised linear model for the main and secondary variables, adjusted according to patient severity and adherence to SADC recommendations. All analyses will be executed by intent to deal with. A model of structural equations (ESQ program) will be applied to contrast a model of causal relationships between sociodemographic and clinical characteristics of the patient, intervention, process variables, self-efficacy of the patient in the management of his or her health and health outcomes. (English)
    12 October 2021
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    Santa Cruz de Tenerife
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    Identifiers

    PI15_01377
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