ENHANCE
Research type
Research Study
Full title
Improving the Care of People with Long Term Conditions (ENHANCE)
IRAS ID
171721
Contact name
Christian Mallen
Contact email
Sponsor organisation
Arthritis Research UK Primary Care Centre, Keele University
Duration of Study in the UK
1 years, 3 months, 30 days
Research summary
For many conditions adherence to guidelines is incentivised by the Quality and Outcomes (QoF) component of the General Practice contract. For some conditions not included in QoF (e.g. osteoarthritis (OA), chronic pain, anxiety), or those conditions with more subjective outcomes (e.g. depression), care frequently remains suboptimal and health needs often go unidentified (Steel et al 2007, Lester et al 2011). As Goodwin et al (2010) note “chronic disease management approaches that identify patients on the severity of a single condition may miss multi-morbid patients who stand to benefit greatly from improved co-ordination of care”.
This pilot trial will examine the feasibility and acceptability of an integrated approach to Long Term Condition (LTC) management by tackling the under-diagnosis and under-management of OA related pain (knee, hip, hand and foot) and anxiety and/or depression in patients aged 45 years and over with other LTCs in primary care (asthma / COPD / hypertension or ischemic heart disease / diabetes), within what we have called an ‘ENHANCE’ LTC review.
This study is a pilot stepped wedge randomised controlled cluster trial that will include 4 GP practices within NIHR Clinical research Network: West Midlands (NIHR CRN: West Midlands). We aim to recruit 300 patients aged 45 years and over with a LTC. A theoretically informed mixed methods approach will be employed using participant self-reported questionnaires, a medical record review, an ‘ENHANCE’ EMIS template, qualitative interviews and audio-recordings of the ‘ENHANCE’ LTC review.
This pilot trial will inform us about the feasibility and acceptability of running a full scale randomised trial, including information about the recruitment and response rates. In addition, this pilot involves interviewing GPs, practice nurses to assess their views and experiences of the ENHANCE LTC review.REC name
North West - Greater Manchester East Research Ethics Committee
REC reference
15/NW/0335
Date of REC Opinion
24 Apr 2015
REC opinion
Favourable Opinion