The primary objective is to evaluate the effect of hospital-initiated and patient-initiated intensive follow-up on medication adherence in patients with chronic neuropathic pain.
ID
Source
Brief title
Condition
- Other condition
Synonym
Health condition
chronische pijn
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
Medication adherence after 11 weeks, assessed by a combination of selfreport
and the Morisky Medication Adherence Scale (MMAS-8).
Secondary outcome
The effect of intensive hospital follow up or patient-initiated follow-up on:
- Pain intensity (NRS)
- Health perception (SF-36)
- Patient satisfaction (1-10)
- Health care costs
Background summary
A lack of adherence is a common problem in patients with chronic non-malignant
pain. Determinants of adherence in chronic pain populations include the
physician-patient relationship, age, polypharmacy, mental disorders, knowledge
of the prescription, and attitudes and concerns towards medication use.
No interventions were described that promote medication adherence. It is
assumed that 'shared decision making', good information and clear agreements on
follow-up facilitate medication adherence. In rheumatoid arthritis patients the
value of patient-initiated follow-up compared to fixed appointments at the
hospital was investigated. In this study, patients themselves determined the
follow-up frequency. This resulted in an improved satisfaction and lower health
care costs. Compliance was not assessed. Long-term outcome of patient-initiated
care was at least as good as hospital-initiated care. Patient initiated care
resulted in lower healthcare costs.
Pharmacological pain therapy consists of initiation of a prescription, and
follow-up afer a few weeks to evaluate the therapy. An intensive follow-up
regimen at the beginning of the therapy result in the possibility to adress
questions and side effects at an earlier stage. By earlier adjusting pain
therapy when needed less time is lost. More frequent follow-up may further
improve the doctor-patient relationship, which is an independant predictor for
medication adherence on its' own.
Study objective
The primary objective is to evaluate the effect of hospital-initiated and
patient-initiated intensive follow-up on medication adherence in patients with
chronic neuropathic pain.
Study design
A randomized controlled clinical trial
Intervention
- control group: standard care, follow-up after 6 and 12 weeks.
- hospital-initiated follow-up: standard care, additional follow-up by phone
after 2,4,8 and 10 weeks.
- patient-initiated care: standard care, additional follow-up at request within
48 hours.
Study burden and risks
There are no risks associated with this research. One disadvantage is the time
investment for patients while completing three questionnaires at home.
koekoekslaan 1
Nieuwegein 3435 CM
NL
koekoekslaan 1
Nieuwegein 3435 CM
NL
Listed location countries
Age
Inclusion criteria
- Diagnosed with chronic neuropathic pain (> 3 months) confirmed by DN4 questionnaire
- 18 years or older
- Able to complete an electronic questionnaire in the Dutch language at home
Exclusion criteria
- patient does not have email access
- patient is treated by primary investigator
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL49682.100.14 |