It is an interventional study that aims to assess a new primary care model of collaboration between specialized centers and primary care physicians in Switzerland, in order to reduce morbidity and improve patients' and providers' experience with delivery of follow-up care in individuals with chronic spinal cord injury as compared to current best practice.
This model will lead to awareness, recognition and interactive communication between GPs and specialists and guidelines on the shared-role relationship. The study interventions are educational modules on bladder, bowel, skin-care, and pain management which will be provided to participating GPs by Spinal Cord Injury specialists. In addition visits by specialized nurses to the participating GPs at their practices to support the establishment of specialized care on-site.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
273
Educational modules on bladder, bowel and skin-care, and pain management will be provided to participating GPs by Spinal Cord Injury specialists
Visits by specialized nurses to the participating GPs at their practices to support the establishment of specialized care on-site
Schweizer Paraplegiker Forschung
Nottwil, Canton of Lucerne, Switzerland
Average difference in total score of Doctor's Opinions on Collaboration (DOC)
DOC is a validated questionnaire covering organization, communication, professional expertise, image and knowing each other. It will be completed by GPs and SCI specialists. The DOC will be converted to an interval score and scaled from 0 to 100 with minimum and maximum score (0=completely agree, 100=completely disagree)
Time frame: Change from baseline to 12 and 24 months post intervention
Average difference in total score of Modified Spinal Cord Injury Secondary Conditions Scale (SCI-SCS) score
Modified Spinal Cord Secondary Conditions Scale (SCI-SCS) targets secondary conditions associated with SCI composite endpoint, excluding diabetes mellitus and joint and muscle pain. Modified (SCI-SCS) includes 14 health conditions and chronic pain. Self reporting through questionnaires on pressure sores, urinary tract infections, spasticity, postural hypotension, bowel, and bladder problems, etc...). The rating scale uses a 4-point ordinal scale ranging from 0 (not experienced/insignificant problem never limiting activity) to 3 (significant/chronic problem).
Time frame: Change from baseline to 12 and 24 months post intervention
Physicians' satisfaction
Questionnaire distributed to physicians in intervention and control group to measure the difference in the satisfaction with the collaboration between the health care providers.
Time frame: Change in overall satisfaction scores from baseline to 12 and 24 months post intervention
Average difference in the number of inpatient hospitalization
Number of hospitalizations people with SCI had in 12 months period
Time frame: Change from baseline to 12 months and 24 months post intervention
Average difference in number of patients visits to a specialist or a SCI center
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Number of visits to SCI specialist of SCI center people with SCI had in 12 months period
Time frame: Change from baseline to 12 and 24 months post intervention
Average difference in subscore on pressure sores
from Modified Spinal Cord Injury Secondary Conditions Scale (SCI-SCS)Subscore on pressure sores with a 4-point rating on severity, ranging from 0 (not experienced/insignificant problem never limiting activity) to 3 (significant/chronic problem)
Time frame: Change from baseline to 12 and 24 months post intervention
Average difference in subscore on UTIs
from Modified Spinal Cord Injury Secondary Conditions Scale (SCI-SCS)Subscore on urinary tract infections (UTIs) with a 4-point rating on severity, ranging from 0 (not experienced/insignificant problem never limiting activity) to 3 (significant/chronic problem)
Time frame: Change from baseline to 12 and 24 months post intervention