A Controlled Trial of Web-Based Diabetes Disease Management: The MGH Diabetes Primary Care Improvement Project

IntroductionMultimorbidity increases care needs and primary care use among people with chronic diseases. The Concerto Health Program (CHP) has been developed to optimise chronic disease management in primary care services. However, in its current version, the CHP primarily targets clinicians and does not aim to answer directly patients’ and their informal caregivers’ needs for chronic disease management. Various studies have shown that interventions that increase patient activation level are associated with better health outcomes. Furthermore, educational tools must be adapted to patients and caregivers in terms of health literacy and usability. This project aims to develop, implement and evaluate a user-centred, multifunctional and personalised eHealth platform (CONCERTO+) to promote a more active patient role in chronic disease management and decision-making.Methods and analysisThis project uses a collaborative research approach, aiming at the personalisation of CHP through three phases: (1) the development of one module of an eHealth platform based on scientific evidence and user-centred design; (2) a feasibility study of CONCERTO+ through a pilot cluster randomised controlled trial where patients with chronic diseases from a primary healthcare practice will receive CONCERTO+ during 6 months and be compared to patients from a control practice receiving usual care and (3) an analysis of CONCERTO+ potential for scaling up. To do so, we will conduct two focus groups with patients and informal caregivers and individual interviews with health professionals at the two study sites, as well as health care managers, information officers and representatives of the Ministry of Health.Ethics and disseminationThis study received ethical approval from Ethics Committee of Université Laval. The findings will be used to inform the effectiveness of CONCERTO+ to improve management care in chronic diseases. We will disseminate findings through presentations in scientific conferences and publication in peer-reviewed journals.Trial registration numberNCT03628963; Pre-results.

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It's LiFe! Mobile and Web-Based Monitoring and Feedback Tool Embedded in Primary Care Increases Physical Activity: A Cluster Randomized Controlled Trial

Journal of Medical Internet Research ◽

10.2196/jmir.4579 ◽

2015 ◽

Vol 17 (7) ◽

pp. e184 ◽

Cited By ~ 50

Author(s):

Sanne van der Weegen ◽

Renée Verwey ◽

Marieke Spreeuwenberg ◽

Huibert Tange ◽

Trudy van der Weijden ◽

...

Keyword(s):

Physical Activity ◽

Primary Care ◽

Randomized Controlled Trial ◽

Controlled Trial ◽

Cluster Randomized Controlled Trial ◽

Web Based ◽

Randomized Controlled ◽

Cluster Randomized

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Effects of a Web-Based Intervention for Stress Reduction in Primary Care: A Cluster Randomized Controlled Trial

Journal of Medical Internet Research ◽

10.2196/jmir.4246 ◽

2016 ◽

Vol 18 (2) ◽

pp. e27 ◽

Cited By ~ 6

Author(s):

Michael Mehring ◽

Max Haag ◽

Klaus Linde ◽

Stefan Wagenpfeil ◽

Antonius Schneider

Keyword(s):

Primary Care ◽

Randomized Controlled Trial ◽

Stress Reduction ◽

Controlled Trial ◽

Cluster Randomized Controlled Trial ◽

Web Based ◽

Randomized Controlled ◽

Cluster Randomized

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Effect of Recruitment Methods on Response Rate in a Web-Based Study for Primary Care Physicians: Factorial Randomized Controlled Trial (Preprint)

10.2196/preprints.8561 ◽

2017 ◽

Author(s):

Ryuhei So ◽

Kiyomi Shinohara ◽

Takuya Aoki ◽

Yasushi Tsujimoto ◽

Aya M Suganuma ◽

...

Keyword(s):

Primary Care ◽

Primary Care Physicians ◽

Response Rate ◽

Controlled Trial ◽

Response Rates ◽

Risk Difference ◽

Web Based ◽

Subject Line ◽

Significant Difference ◽

The Subject

BACKGROUND Low participation rates are one of the most serious disadvantages of Web-based studies. It is necessary to develop effective strategies to improve participation rates to obtain sufficient data. OBJECTIVE The objective of this trial was to investigate the effect of emphasizing the incentive in the subject line of the invitation email and the day of the week of sending the invitation email on the participation rate in a Web-based trial. METHODS We conducted a 2×2 factorial design randomized controlled trial. We contacted 2000 primary care physicians from members of the Japan Primary Care Association in January 2017 and randomly allocated them to 1 of 4 combinations of 2 subject lines (presence or absence of an emphasis on a lottery for an Amazon gift card worth 3000 yen or approximately US $30) and 2 delivery days (sending the invitation email on Tuesday or Friday). The primary outcome was the response rate defined as the number of participants answering the first page of the questionnaire divided by the number of invitation emails delivered. All outcomes were collected between January 17, 2017, and February 8, 2017. RESULTS We analyzed data from 1943 out of 2000 participants after excluding those whose email addresses were invalid. The overall response rate was 6.3% (123/1943). There was no significant difference in the response rates between the 2 groups regarding incentive in the subject line: the risk ratio was 1.12 (95% CI 0.80 to 1.58) and the risk difference was 0.7% (95% CI –1.5% to 2.9%). Similarly, there was no significant difference in the response rates between the 2 groups regarding sending the email on Tuesday or Friday: the risk ratio was 0.98 (95% CI 0.70 to 1.38) and the risk difference was –0.1% (95% CI –2.3% to 2.1%). CONCLUSIONS Neither emphasizing the incentive in the subject line of the invitation email nor varying the day of the week the invitation email was sent led to a meaningful increase in response rates in a Web-based trial with primary care physicians. CLINICALTRIAL University Hospital Medical Information Network Clinical Trials Registry UMIN000025317; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000029121 (Archived by WebCite at http://www.webcitation. org/6wOo1jl9t)

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