Improving the Care of People with Long-Term Conditions in Primary Care: Protocol for the Enhance Pilot Trial
Background Long-term conditions (LTCs) are important determinants of quality of life and healthcare expenditure worldwide. Whilst multimorbidity is increasingly the norm in primary care, clinical guidelines and the delivery of care remain focused on single diseases, resulting in poorer clinical outc...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2015-01-01
|
| Series: | Journal of Comorbidity |
| Online Access: | https://doi.org/10.15256/joc.2015.5.60 |
| _version_ | 1818420143212986368 |
|---|---|
| author | Emma L. Healey Clare Jinks Valerie A. Tan Carolyn A. Chew-Graham Sarah A. Lawton Elaine Nicholls Andrew G. Finney Mark Porcheret Vince Cooper Martyn Lewis Krysia S. Dziedzic Simon Wathall Christian D. Mallen |
| author_facet | Emma L. Healey Clare Jinks Valerie A. Tan Carolyn A. Chew-Graham Sarah A. Lawton Elaine Nicholls Andrew G. Finney Mark Porcheret Vince Cooper Martyn Lewis Krysia S. Dziedzic Simon Wathall Christian D. Mallen |
| author_sort | Emma L. Healey |
| collection | DOAJ |
| description | Background Long-term conditions (LTCs) are important determinants of quality of life and healthcare expenditure worldwide. Whilst multimorbidity is increasingly the norm in primary care, clinical guidelines and the delivery of care remain focused on single diseases, resulting in poorer clinical outcomes. Osteoarthritis, and anxiety and/or depression frequently co-occur with other LTCs, yet are seldom prioritized by the patient or clinician, resulting in higher levels of disability, poorer prognosis, and increased healthcare costs. Objective To examine the feasibility and acceptability of an integrated approach to LTC management, tackling the under-diagnosis and under-management of osteoarthritis-related pain and anxiety and/or depression in older adults with other LTCs in primary care. Design The ENHANCE study is a pilot stepped-wedge cluster randomized controlled trial to test the feasibility and acceptability of a nurse-led ENAHNCE LTC review consultation for identifying, assessing, and managing joint pain, and anxiety and/or depression in patients attending LTC reviews. Specific objectives (process evaluation and research outcomes) will be achieved through a theoretically informed mixed-methods approach using participant self-reported questionnaires, a medical record review, an ENHANCE EMIS template, qualitative interviews, and audio recordings of the ENHANCE LTC review. Discussion Success of the pilot trial will be measured against the level of the primary care team engagement, assessment of training delivery, and degree of patient recruitment and retention. Patient satisfaction and treatment fidelity will also be explored. ISRCTN registry number: 12154418. |
| first_indexed | 2024-12-14T12:49:47Z |
| format | Article |
| id | doaj.art-7958d82ce49143e9860f7d948f6b76af |
| institution | Directory Open Access Journal |
| issn | 2235-042X |
| language | English |
| last_indexed | 2024-12-14T12:49:47Z |
| publishDate | 2015-01-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Comorbidity |
| spelling | doaj.art-7958d82ce49143e9860f7d948f6b76af2022-12-21T23:00:42ZengSAGE PublishingJournal of Comorbidity2235-042X2015-01-01510.15256/joc.2015.5.60Improving the Care of People with Long-Term Conditions in Primary Care: Protocol for the Enhance Pilot TrialEmma L. HealeyClare JinksValerie A. TanCarolyn A. Chew-GrahamSarah A. LawtonElaine NichollsAndrew G. FinneyMark PorcheretVince CooperMartyn LewisKrysia S. DziedzicSimon WathallChristian D. MallenBackground Long-term conditions (LTCs) are important determinants of quality of life and healthcare expenditure worldwide. Whilst multimorbidity is increasingly the norm in primary care, clinical guidelines and the delivery of care remain focused on single diseases, resulting in poorer clinical outcomes. Osteoarthritis, and anxiety and/or depression frequently co-occur with other LTCs, yet are seldom prioritized by the patient or clinician, resulting in higher levels of disability, poorer prognosis, and increased healthcare costs. Objective To examine the feasibility and acceptability of an integrated approach to LTC management, tackling the under-diagnosis and under-management of osteoarthritis-related pain and anxiety and/or depression in older adults with other LTCs in primary care. Design The ENHANCE study is a pilot stepped-wedge cluster randomized controlled trial to test the feasibility and acceptability of a nurse-led ENAHNCE LTC review consultation for identifying, assessing, and managing joint pain, and anxiety and/or depression in patients attending LTC reviews. Specific objectives (process evaluation and research outcomes) will be achieved through a theoretically informed mixed-methods approach using participant self-reported questionnaires, a medical record review, an ENHANCE EMIS template, qualitative interviews, and audio recordings of the ENHANCE LTC review. Discussion Success of the pilot trial will be measured against the level of the primary care team engagement, assessment of training delivery, and degree of patient recruitment and retention. Patient satisfaction and treatment fidelity will also be explored. ISRCTN registry number: 12154418.https://doi.org/10.15256/joc.2015.5.60 |
| spellingShingle | Emma L. Healey Clare Jinks Valerie A. Tan Carolyn A. Chew-Graham Sarah A. Lawton Elaine Nicholls Andrew G. Finney Mark Porcheret Vince Cooper Martyn Lewis Krysia S. Dziedzic Simon Wathall Christian D. Mallen Improving the Care of People with Long-Term Conditions in Primary Care: Protocol for the Enhance Pilot Trial Journal of Comorbidity |
| title | Improving the Care of People with Long-Term Conditions in Primary Care: Protocol for the Enhance Pilot Trial |
| title_full | Improving the Care of People with Long-Term Conditions in Primary Care: Protocol for the Enhance Pilot Trial |
| title_fullStr | Improving the Care of People with Long-Term Conditions in Primary Care: Protocol for the Enhance Pilot Trial |
| title_full_unstemmed | Improving the Care of People with Long-Term Conditions in Primary Care: Protocol for the Enhance Pilot Trial |
| title_short | Improving the Care of People with Long-Term Conditions in Primary Care: Protocol for the Enhance Pilot Trial |
| title_sort | improving the care of people with long term conditions in primary care protocol for the enhance pilot trial |
| url | https://doi.org/10.15256/joc.2015.5.60 |
| work_keys_str_mv | AT emmalhealey improvingthecareofpeoplewithlongtermconditionsinprimarycareprotocolfortheenhancepilottrial AT clarejinks improvingthecareofpeoplewithlongtermconditionsinprimarycareprotocolfortheenhancepilottrial AT valerieatan improvingthecareofpeoplewithlongtermconditionsinprimarycareprotocolfortheenhancepilottrial AT carolynachewgraham improvingthecareofpeoplewithlongtermconditionsinprimarycareprotocolfortheenhancepilottrial AT sarahalawton improvingthecareofpeoplewithlongtermconditionsinprimarycareprotocolfortheenhancepilottrial AT elainenicholls improvingthecareofpeoplewithlongtermconditionsinprimarycareprotocolfortheenhancepilottrial AT andrewgfinney improvingthecareofpeoplewithlongtermconditionsinprimarycareprotocolfortheenhancepilottrial AT markporcheret improvingthecareofpeoplewithlongtermconditionsinprimarycareprotocolfortheenhancepilottrial AT vincecooper improvingthecareofpeoplewithlongtermconditionsinprimarycareprotocolfortheenhancepilottrial AT martynlewis improvingthecareofpeoplewithlongtermconditionsinprimarycareprotocolfortheenhancepilottrial AT krysiasdziedzic improvingthecareofpeoplewithlongtermconditionsinprimarycareprotocolfortheenhancepilottrial AT simonwathall improvingthecareofpeoplewithlongtermconditionsinprimarycareprotocolfortheenhancepilottrial AT christiandmallen improvingthecareofpeoplewithlongtermconditionsinprimarycareprotocolfortheenhancepilottrial |