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Intervention (GUT LINK Tool) was implemented outside of the context of a research study at our care centre, the QEII, as quality improvement. It became infeasible to consent all physicians to use the tool, and carry out this study.
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| Name | Class |
|---|---|
| Nova Scotia Health Authority | OTHER |
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It can be challenging for Primary Healthcare Providers (PHCPs) to differentiate between IBS and more serious illnesses involving the GI tract, such as Crohn's disease, ulcerative colitis, or cancer. To help with diagnosis and treatment of IBS, evidence-based guidelines have been developed. However, they are not commonly used in primary care practice and PHCPs and patients often feel that GI specialist evaluation and endoscopy is required. The development of care pathways and clinical practice guidelines is essential to support the investigation and management of digestive diseases, such as IBS.
The current pilot study is designed to assess the implementation and early comparative effectiveness of a Clinical Care Pathway for lower GI tract symptoms.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| GUT LINK SmartPath | Experimental | physicians will use the interactive GUT LINK Smartpath tool in virtual hallway platform to guide their care and referral practices |
|
| control | No Intervention | physicians will provide care and refer as per their usual practices |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| GUT LINK SmartPath | Behavioral | A virtual care delivery and referral support tool for primary healthcare providers. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of users | Number of users (an indicator of prototype acceptability) | month 3 |
| Number of users | Number of users (an indicator of prototype acceptability) | month 6 |
| Number of referrals | Number of referrals from GPs to GI Department (an indicator of prototype acceptability) | month 3 |
| Number of referrals | Number of referrals from GPs to GI Department (an indicator of prototype acceptability) | month 6 |
| Number of referrals per week | Number of referrals per week from GPs to GI Department (an indicator of prototype acceptability) | month 3 |
| Number of referrals per week | Number of referrals per week from GPs to GI Department (an indicator of prototype acceptability) | month 6 |
| Number of referrals per user | Number of referrals per week from GPs to GI Department (an indicator of prototype acceptability) | month 3 |
| Number of referrals per user | Number of referrals per week from GPs to GI Department (an indicator of prototype acceptability) |
| Measure | Description | Time Frame |
|---|---|---|
| Number referrals received as per prototype | Number referrals received as per prototype (an implementation metric) | month 3 |
| Number referrals received as per prototype | Number referrals received as per prototype (an implementation metric) |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| QEII Health Sciences Centre | Halifax | Nova Scotia | B3N 2Z6 | Canada |
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| ID | Term |
|---|---|
| D043183 | Irritable Bowel Syndrome |
| D004066 | Digestive System Diseases |
| ID | Term |
|---|---|
| D003109 | Colonic Diseases, Functional |
| D003108 | Colonic Diseases |
| D007410 | Intestinal Diseases |
| D005767 | Gastrointestinal Diseases |
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| month 6 |
| Number of clicks per referral | Number of clicks per referral from GPs to GI Department (an indicator of prototype acceptability) | month 3 |
| Number of clicks per referral | Number of clicks per referral from GPs to GI Department (an indicator of prototype acceptability) | month 6 |
| Primary Healthcare Provider Satisfaction | Thematic analysis of interviews of primary care providers will yield key themes related to satisfaction with the intervention. | baseline (month 0) |
| Primary Healthcare Provider Satisfaction | Thematic analysis of interviews of primary care providers will yield key themes related to satisfaction with the intervention. | month 6 |
| month 6 |
| Number of referrals received requiring troubleshooting | Number of referrals received requiring troubleshooting (an implementation metric) | month 3 |
| Number of referrals received requiring troubleshooting | Number of referrals received requiring troubleshooting (an implementation metric) | month 6 |
| Number of referrals aborted | Number of referrals aborted (an implementation metric) | month 3 |
| Number of referrals aborted | Number of referrals aborted (an implementation metric) | month 6 |
| Type of consult | Type of consult (Full consult, specialist telephone advice, eConsult) | month 3 |
| Type of consult | Type of consult (Full consult, specialist telephone advice, eConsult) | month 6 |
| Perceived appropriateness of the SmartPath | Thematic analysis of interviews of primary care providers will yield key themes related to the perceived appropriateness of the intervention | month 3 |
| Perceived appropriateness of the SmartPath | Thematic analysis of interviews of primary care providers will yield key themes related to the perceived appropriateness of the intervention | month 6 |
| physician self-efficacy rating | physician self-efficacy rating, measured using the 'New General Self Efficacy Scale' (an effectiveness metric of GUT LINK Smartpath). Min score: 1, max score: 8. A higher score indicates a greater self-efficacy. | month 3 |
| physician self-efficacy rating | physician self-efficacy rating, measured using the 'New General Self Efficacy Scale' (an effectiveness metric of GUT LINK Smartpath). Min score: 1, max score: 8. A higher score indicates a greater self-efficacy. | month 6 |
| Referral triage priority category | Referral triage priority category will be collected from referrals through the pathway (an effectiveness metric of GUT LINK Smartpath). Referral triage categories to the GI department are: emergent, semi urgent, and non-urgent. | month 3 |
| Referral triage priority category | Referral triage priority category will be collected from referrals through the pathway (an effectiveness metric of GUT LINK Smartpath). Referral triage categories to the GI department are: emergent, semi urgent, and non-urgent. | month 6 |
| Time from referral to specialist consultation | Time from referral to specialist consultation, in weeks (an effectiveness metric of GUT LINK Smartpath) | month 3 |
| Time from referral to specialist consultation | Time from referral to specialist consultation, in weeks (an effectiveness metric of GUT LINK Smartpath) | month 6 |
| Time from referral to diagnosis and treatment | Time from referral to diagnosis and treatment, in weeks (an effectiveness metric of GUT LINK Smartpath) | month 3 |
| Time from referral to diagnosis and treatment | Time from referral to diagnosis and treatment, in weeks (an effectiveness metric of GUT LINK Smartpath) | month 6 |