Shared Responsibility Between General Practitioners and Highly Specialized Hospitals in Spinal Cord Injury (SCICO)

Schweizer Paraplegiker Forschung

Status: Unknown

Conditions: Spinal Cord Injuries

Treatments: Other: Site visits to GP practices; Other: Teaching to GPs

Study type: Interventional

Funder types: Other

Identifiers

NCT04071938

SCICO

Details and patient eligibility

About

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.

Full description

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.

Enrollment: 273 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

Physicians

• GPs practicing in medium to large group practice
• The practice is wheelchair accessible and remote to SCI specialized centers
• Proficiency certificate in ultrasonography

Patients:

• Diagnosed with traumatic or non-traumatic, sensory or motor complete or incomplete, chronic SCI
• 18 years or older
• Permanently reside in Switzerland
• Reside farther than 25 minutes driving distance from a specialized SCI center
• Understand German, English, Italian
• Informed consent
• Additionally in treatment group: Patients with chronic SCI Living in the region of a participating GP irrespective if they visit the participating primary care practice.
• Additionally in control group: individuals with SCI who live outside the catchment areas

Exclusion criteria

Patients:

• Acute SCI or during first rehabilitation phase - Congenital conditions leading to paraplegia or tetraplegia, including spina bifida - Neurodegenerative disorders such as multiple sclerosis and amyotrophic lateral sclerosis - Guillain-Barré syndrome

Trial design

Primary purpose: Health Services Research

Allocation: Non-Randomized

Interventional model: Single Group Assignment

Masking: None (Open label)

---

273 participants in 2 patient groups

Intervention group

Active Comparator group

Description:

Physicians: 10 GPs from 10 practices who treat patient with Spinal cord injury (SCI) and 10 SCI specialists. Patients: 270 people with SCI within 25 minutes vehicle driving distance to the GP practices will be in the intervention group

Treatment:

Other: Teaching to GPs

Other: Site visits to GP practices

Control group

No Intervention group

Description:

Physicians: 20 GPs who treat patient with SCI will not receive any intervention. They will be completing the questionnaire (DOC) and assessed for satisfaction with collaboration with the SCI specialist. Patients: 210 people with spinal cord injury outside the catchment area of the intervention group will be receiving usual care (no intervention)