This research project aims to test if systematic (extensive) use of patient-reported outcomes across treatment boundaries can 1. improve patients' and health professionals' understanding of individual patients' conditions and health changes, 2. improve indications for treatment, 3. strengthen patient empowerment, and 4. reduce patients' utilization of health services. The study will be performed in the particular context of patients with chronic degenerative conditions of the shoulder. These patients are characterized by contact with numerous health professionals from different health sectors, such as general practitioner, physiotherapists and surgical referral centres, which challenges coherence and communication for the individual treatment decisions. The research project will be performed as a randomized controlled trial (RCT) with a 1-year inclusion period and two years of follow-up.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE
Enrollment
1,000
Se description of the arms
Department of Physiotherapy, Univesity Hospital Gentofte
Gentofte Municipality, Hellerup, Denmark
Genoptræning og Rehabilitering, Rødovre Kommune
Rødovre Municipality, Rødovre, Denmark
Privathospitalet Danmark
Charlottenlund, Denmark
Department of rehabilitation, Gentofte Kommune
Hellerup, Denmark
Division of shoulder and elbow surgery, Department of orthopaedics, Univesity Hospital Gentofte
Hellerup, Denmark
Mit Lægehus
Rødovre Municipality, Denmark
Treatment cost per change in life quality
The treatment cost during the study period expressed as the cost per improvement in life quality, similar to the cost per QALY (quality adjusted life years). The total cost will be calculated from hospital contacts, physiotherapy sessions and primary healthcare contacts. The EQ5D-5L will be used as a generic life quality measure. The primary outcome for the intervention and control group will be compared.
Time frame: From inclusion time and the 2 following years.
Treatment cost per change in life quality stratisfied according to the specific shoulder diagnosis
The same as primary outcome, but stratified according to the specific shoulder diagnosis
Time frame: From inclusion time and the 2 following years
Patient satisfaction with the treatment of their shoulder problem
Measured by questionaire (specifically the question "are you satisfied with the treatment fo your shoulder so far"?
Time frame: From inclusion time and the 2 following years
Number of patients treated with surgery
To evaluate if any difference in referral to surgery occurs between the intervention group and the control group, and analyse if any reasons for a difference can be identified
Time frame: From inclusion time and the 2 following years
Number of contacts with either the hospital or the family doctor due to problems with the treated shoulder
To evaluate if any difference in medical contacts due to the treated shoulder occurs between the intervention and the control groups, and analyse if any reasons for a difference can be identified
Time frame: From inclusion time and the 2 following years
Number and types of complications during the treatment of the shoulder problem
To evaluate if any difference in complications in relation to the treatment of the shoulder occurs between the intervention and the control groups, and analyse if any reasons for a difference can be identified
Time frame: From inclusion time and the 2 following years
For patients still working: Number and duration (measured in days) of any periods of sick-leave/unemployment due to the shoulder problem
To evaluate if any difference in employment-status and/or sick-leave occurs between the intervention and the control groups, and analyse if any reasons for a difference can be identified
Time frame: From inclusion time and the 2 following years
Development in the PRO score, represented by Oxford Shoulder Score, over time for each specific shoulder disease
To evaluate the development of PRO scores during a treatment of the included shoulder diseases with regards to the different treatment options, to create a reference for future treatments of these patients
Time frame: From inclusion time and the 2 following years
PRO score, represented by Oxford Shoulder Score, as predictors?
To evaluate if a PRO score can differentiate patients with regards to who might benefit from specific treatment regimens/effect of treatments measured by PRO
Time frame: From inclusion time and the 2 following years
If use of systematic PRO scores, represented by Oxford Shoulder Score, changes the referral-pattern between the involved sectors
To evaluate if PRO scores has the potential to be used to screen patients before making a referral between sectors
Time frame: From inclusion time and the 2 following years
Health professionals' assessments of history and usefulness of the prognosis tools developed for this study (the Database setup in Procordo).
To evaluate if the involved professionals experience any gain in the use of the PRO scores in the daily treatment of the patients. This will be evaluated at every visit with the patient by a questionaire to the treating professionals.
Time frame: From inclusion time and the 2 following years
Patient satisfaction with the PRO score system build in the Database system (Procordo)
Satisfaction and qualitative assessment of history and prognosis tool (intervention group only). This will be investigated by questionaire in relation to the completion of the PROs every 3 month during the study period.
Time frame: From inclusion time and the 2 following years
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