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面向患者的肺癌或中风患者导航方案在德国的可行性:CoreNAVI 研究方案。

Feasibility of a patient-oriented navigation programme for patients with lung cancer or stroke in Germany: Protocol of the CoreNAVI study.

机构信息

Institute of Public Health, Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.

Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Berlin, Germany.

出版信息

PLoS One. 2023 Jun 29;18(6):e0287638. doi: 10.1371/journal.pone.0287638. eCollection 2023.

Abstract

BACKGROUND

Patient navigation programmes were introduced in the United States and recently gained interest in Germany, where the health care system is fragmented. Navigation programmes aim to decrease barriers to care for patients with age-associated diseases and complex care paths. Here we describe a feasibility study to evaluate a patient-oriented navigation model that was developed in a first project phase by integrating data about barriers to care, vulnerable patient populations and existing support services.

METHODS

We designed a mixed-methods feasibility study that consists of two two-arm randomized controlled trials aligned with observational cohorts. The intervention group of the RCTs gets support by personal navigators for 12 months. The control group receives a brochure with regional support offers for patients and caregivers. The feasibility of the patient-oriented navigation model for two prototypic age-associated diseases, lung cancer and stroke, is evaluated with regard to its acceptance, demand, practicality and efficacy. This investigation includes process evaluation measures with detailed documentation of the screening and recruitment process, questionnaires about satisfaction with navigation, observant participation and qualitative interviews. Estimates of efficacy for patient-reported outcomes are obtained at three follow-up time points including satisfaction with care and health-related quality of life. Furthermore, we analyze health insurance data from patients of the RCT insured at a large German health insurance (AOK Nordost) to investigate heath care utilization, costs and cost effectiveness.

TRIAL REGISTRATION

The study is registered at the German Clinical Trial Register (DRKS-ID: DRKS00025476).

摘要

背景

患者导航计划在美国推出,最近在医疗体系碎片化的德国引起了关注。这些计划旨在减少与年龄相关疾病和复杂护理路径相关的患者的护理障碍。在这里,我们描述了一项可行性研究,以评估一种以患者为导向的导航模型,该模型在第一阶段的项目中通过整合有关护理障碍、弱势患者群体和现有支持服务的数据来开发。

方法

我们设计了一项混合方法可行性研究,包括两个与观察队列对齐的两臂随机对照试验。RCT 组的干预组将获得为期 12 个月的个人导航员的支持。对照组将收到一份针对患者和照顾者的区域支持服务的小册子。通过详细记录筛选和招募过程的过程评估措施、关于导航满意度的问卷调查、观察性参与和定性访谈,评估面向患者的导航模型在两种典型的与年龄相关的疾病(肺癌和中风)中的适用性、需求、实用性和疗效。在三个随访时间点,包括对护理满意度和健康相关生活质量的评估,估计患者报告结果的疗效。此外,我们分析了接受大型德国健康保险公司(AOK Nordost)保险的 RCT 患者的健康保险数据,以调查医疗保健的利用、成本和成本效益。

试验注册

该研究在德国临床试验注册处(DRKS-ID:DRKS00025476)注册。

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