Effectiveness of an evidence-based care pathway to improve mobility and participation in older patients with vertigo and balance disorders in primary care (MobilE-PHY2): study protocol for a multicentre cluster-randomised controlled trial

Trials

Study Protocol

Juliane Köberlein-Neu¹  Theresia Kiesel²  Stefanie Skudlik²  Tobias Döringer²  Martin Müller³  Caren Horstmannshoff⁴  Joachim Hermsdörfer⁵  Petra Bauer⁶  Jenny Petermann⁷  Karen Voigt⁷  Klaus Jahn⁸  Alexander Crispin⁹  Stefan Schädler^1,10 

[1] Center for Health Economics and Health Services Research, University of Wuppertal, Rainer-Gruenter-Str. 21, 42119, Wuppertal, Germany;Centre for Research, Development and Technology Transfer, Rosenheim Technical University of Applied Sciences, Hochschulstr. 1, 83024, Rosenheim, Germany;Centre for Research, Development and Technology Transfer, Rosenheim Technical University of Applied Sciences, Hochschulstr. 1, 83024, Rosenheim, Germany;Department of Primary Care and Health Services Research, Medical Faculty, Heidelberg University, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany;Centre for Research, Development and Technology Transfer, Rosenheim Technical University of Applied Sciences, Hochschulstr. 1, 83024, Rosenheim, Germany;Department of Sport and Health Sciences, Chair of Human Movement Science, Technical University of Munich, Georg-Brauchle-Ring 60/62, 80992, Munich, Germany;Department of Sport and Health Sciences, Chair of Human Movement Science, Technical University of Munich, Georg-Brauchle-Ring 60/62, 80992, Munich, Germany;Faculty of Applied Health and Social Sciences, Rosenheim Technical University of Applied Sciences, Hochschulstr. 1, 83024, Rosenheim, Germany;Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 1307, Dresden, Germany;German Centre for Vertigo and Balance Disorders, Ludwig-Maximilian University of Munich, Marchioninistraße 15, 81377, Munich, Germany;Schoen Clinic Bad Aibling, Kolbermoorer Str. 72, 83043, Bad Aibling, Germany;Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilian University of Munich, Marchioninistr. 15, 81377, Munich, Germany;Physiotherapie im Schloss, Schloss 88, 3454, Sumiswald, Switzerland;

关键词: Dizziness;    Vertigo;    Balance disorder;    Complex intervention;    Primary care;    Care pathway;    Multicentre cluster randomised controlled trial;    Mobility;    Physiotherapy;   

DOI  :  10.1186/s13063-022-07017-x

 received in 2022-10-26, accepted in 2022-12-15,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundVertigo, dizziness or balance disorders (VDB) are common leading symptoms in older people, which can have a negative impact on their mobility and participation in daily live, yet, diagnosis is challenging and specific treatment is often insufficient. An evidence-based, multidisciplinary care pathway (CPW) in primary care was developed and pilot tested in a previous study. The aim of the present study is to evaluate the effectiveness and safety of the CPW in terms of improving mobility and participation in community-dwelling older people with VDB in primary care.MethodsFor this multicentre cluster randomised controlled clinic trial, general practitioners (GP) will be recruited in two regions of Germany. A total of 120 patients over 60 years old with VDB will be included. The intervention is an algorithmized CPW. GPs receive a checklist for standardise clinical decision making regarding diagnostic screening and treatment of VDB. Physiotherapists (PT) receive a decision tree for evidence-based physiotherapeutic clinical reasoning and treatment of VDB. Implementation strategies comprises educational trainings as well as a workshop to give a platform for exchange for the GPs and PTs, an information meeting and a pocket card for home care nurses and informal caregivers and telephone peer counselling to give all participants the capability, opportunity and the motivation to apply the intervention. In order to ensure an optimised usual care in the control group, GPs get an information meeting addressing the national guideline. The primary outcome is the impact of VDB on participation and mobility of patients after 6 month follow-up, assessed using the Dizziness Handicap Inventory (DHI) questionnaire. Secondary outcomes are physical activity, static and dynamic balance, falls and fear of falling as well as quality of life. We will also evaluate safety and health economic aspects of the intervention. Behavioural changes of the participants as well as barriers, facilitating factors and mechanisms of impact of the implementation will be investigated with a comprehensive process evaluation in a mixed-methods design.DiscussionWith our results, we aim to improve evidence-based health care of community-dwelling older people with VDB in primary care.Trial registrationDRKS, DRKS00028524 retrospectively registered on March 24, 2022.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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