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OpenTrials
Completed

NCT Number: NCT05611008

Testing the SNOWDROP Intervention: Using a Clinical Decision Support System and Patient Portal for Falls Prevention Among Older Patients in Primary Care

Falls are a leading cause of injuries among older patients. Medication use is a major risk factor for falls. Because we lack tools to assess individualized risks, general practitioners (GPs) struggle with fall-related medication management for older patients. Furthermore, these older patients are often not properly equipped to engage in the joint management of their medication. A Clinical Decision Support System (CDSS) for GPs and a patient portal for older patients may stimulate shared decision making between GPs and older patients when discussing the medication-related fall risk. The CDSS provides the GP with advice on how to alter medication in such a way that the fall risk decreases, and the patient portal helps the older patient to prepare for a consultation and to engage in the joint management of their medication.

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Key information

Conditions

Fall Accidental Fall Deprescribing Fall Injury Fall Patients

Age range

70 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Huisartsenpraktijken

Amsterdam, Netherlands

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Aged 70 years or older
  • High fall risk
  • Takes at least 1 Fall Risk Increasing Drug (FRID)

Treatment and study plan

CDSS

Device

A Clinical Decision Support System (CDSS) that calculates older patients' personalized fall risk and provides the GP with advice on how to adjust the patient's medication in order to lower the fall risk.

Patient Portal

Device

A patient portal that provides general information on falls and fall risk to the older patients and helps the patient to prepare for the consultation by filling out a Question Prompt List (QPL). The QPL is a list of possibly relevant questions and topics from which the patient can select those that are important to him/her. These will already be sent to the GP before the consultation takes place.

Primary outcomes

  1. Shared decision making

    Time frame: During consultation

    This concerns the extent to which shared decision making between patient and GP during the consultation. This will be assessed using the Observer OPTION Multiple Chronic Conditions (OPTION-MCC). Consultation are audiotaped and will be coded on shared decision making using this coding scheme.

Secondary outcomes

  1. Technology Acceptance Model (TAM; patient portal)

    Time frame: At baseline & two weeks after consultation

    The Technology Acceptance Model (TAM) measures the adoption of a new technology/system based on user attitudes in relation to the patient portal.

  2. Website Satisfaction Scale (WSS; patient portal)

    Time frame: At baseline & two weeks after consultation

    The Website Satisfaction Scale (WSS) measures satisfaction with comprehensibility, satisfaction with attractiveness, and satisfaction with emotional support, in relation to the patient portal.

  3. Patient portal usage

    Time frame: At baseline & two weeks after consultation

    Patients are asked if they used the patient portal and which components they used.

  4. Beliefs About Medicines Questionnaire (BMQ)

    Time frame: Baseline & two weeks after consultation

    The Beliefs about Medicines Questionnaire measures beliefs about the necessity of medication and concerns about medication.

  5. Netherlands Patient Information Recall Questionnaire (NPIRQ)

    Time frame: Two weeks after consultation

    The Netherlands Patient Information Recall Questionnaire consists of open questions measuring patients' recall of what was discussed and decided during the consultation.

  6. Decisional Conflict Scale (DCS)

    Time frame: Two weeks after consultation

    The decisional conflict scale measures decisional conflict after the consultation related to five subscales: feeling informed, uncertainty, values clarity, support, and effective decision making.

  7. Changes in medication

    Time frame: Baseline & two weeks after the consultation

    Changes in prescriptions of the medication as reported in the electronic health record.

  8. Technology Acceptance Model (TAM; CDSS)

    Time frame: After the first consultation (study beginning) and after the last consultation (study completion after +/- 7 months)

    The Technology Acceptance Model (TAM) measures the adoption of a new technology/system based on user attitudes in relation to the CDSS to be answered by the GP. This is assessed by measuring Perceived Usefulness, Perceived Ease of Use, and Intention to use.

  9. The Website Satisfaction Scale (WSS; CDSS)

    Time frame: After the first consultation (study beginning) and after the last consultation (study completion after +/- 7 months)

    The Website Satisfaction Scale (WSS) measures satisfaction with comprehensibility, satisfaction with attractiveness, and satisfaction with emotional support, in relation to the CDSS to be answered by the GP.

  10. Evaluation of the consultation

    Time frame: Immediately after each consultation

    Four items to assess the consultation to be answered by the GP. The items assess to what extent the patient was representative, their opinion on the communication during the consultation, the extent to which they are satisfied with any decisions made and the difficulty of the consultation.

Sponsors and collaborators

Lead sponsor

University of Amsterdam

Other

Registry information

Official study title

Seniors Empowered Via Big Data to Joint-manage Their Medication-related Risk of Falling in Primary Care

Acronym: SNOWDROP

Important dates

Study start
2022
Primary completion
2023
Study completion
2023
First posted
Nov 9, 2022
Registry last updated
Jan 10, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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