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Effects of 'NHGDoc' on Quality of Care (NHGDoc)

The recruitment status of this study is unknown. The completion date has passed and the status has not been verified in more than two years.
Verified May 2015 by Radboud University.
Recruitment status was:  Active, not recruiting
Netherlands: Ministry of Health, Welfare and Sports
Information provided by (Responsible Party):
Radboud University Identifier:
First received: November 22, 2012
Last updated: May 6, 2015
Last verified: May 2015
The purpose of this study is to determine whether the computerized decision support system 'NHGDoc' is effective in improving quality of primary care in terms of processes of care (e.g. prescribing behavior of physicians) as well as outcomes of care (e.g. hospital admissions, mortality).

Condition Intervention Phase
Heart Failure
Other: NHGDoc domain Heart Failure
Early Phase 1

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double Blind (Participant, Care Provider)
Primary Purpose: Treatment
Official Title: Effects of the Computerized Decision Support System 'NHGDoc' on Quality of Care: a Cluster Randomized Controlled Trial

Resource links provided by NLM:

Further study details as provided by Radboud University:

Primary Outcome Measures:
  • Prescribing of ACE-inhibitors/Angiotensin II [ Time Frame: One year ]
    Percentage of patients with heart failure that is prescribed ACE-inhibitors/Angiotensin II

  • Prescribing of beta blockers [ Time Frame: One year ]
    Percentage of heart failure patients that is prescribed beta blockers

  • Prescribing of diuretics [ Time Frame: One year ]
    Percentage of heart failure patients that is prescribed diuretics

Secondary Outcome Measures:
  • Hospital admissions [ Time Frame: One year ]
    Number of hospital admissions of patients with heart failure

  • All cause mortality [ Time Frame: One year ]
    Number of patients with heart failure that die within the hospital

Estimated Enrollment: 120
Study Start Date: April 2013
Estimated Study Completion Date: May 2016
Primary Completion Date: May 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Active decision support
Regular NHGDoc domains plus NHGDoc domain heart failure
Other: NHGDoc domain Heart Failure
Healthcare providers receive patient specific alerts in terms of diagnosing and treatment of patients with heart failure
No Intervention: Passive decision support
Regular NHGDoc domains

Detailed Description:

Computerized decision support systems are regarded as useful tools to improve quality of care, but their effects are still uncertain. In the Netherlands 'NHGDoc' a computerized decision support system supported by the Dutch College of General Practitioners (NHG) is currently being implemented among more than 1.000 general practices in the Netherlands.

The aim of this study is to evaluate the effects of NHGDoc on quality of care. In addition, we want to gain insight into the barriers and facilitators that affect the systems' impact.

A cluster randomized controlled trial will be conducted among 120 general practices in the Netherlands. Eligible practices will be randomized to receive either the regular NHGDoc modules (control arm) or the regular modules and an additional module on heart failure (intervention arm). The effect evaluation will focus on processes of care (e.g. prescription behavior) as well as on patient outcomes (e.g. hospital admissions, mortality). Additionally, a process evaluation will be conducted, which includes a focus group study and a survey among participating healthcare providers to evaluate the perceived barriers and facilitators to using 'NHGDoc'.

Results of this study will provide insight in the ability of computerized decision support systems and in particular 'NHGDoc' to improve quality of primary care. Whereas the trial focuses on a specific NHGDoc domain - heart failure - we believe our conclusions are relevant to other primary care areas as well, particularly as this study also explores the factors that contribute to the systems' effectiveness.


Ages Eligible for Study:   Child, Adult, Senior
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • General practices should use the information system MicroHIS X or Promedico ASP
  • NHGDoc should be available in the general practices

Exclusion Criteria:

  • General practices that do not meet the inclusion criteria
  Contacts and Locations
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Please refer to this study by its identifier: NCT01773057

Radboud University Nijmegen Medical Centre, IQ healthcare
Nijmegen, Netherlands, 6500 HB
Sponsors and Collaborators
Radboud University
Netherlands: Ministry of Health, Welfare and Sports
Principal Investigator: Tijn Kool, PhD IQ healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
  More Information

Publications automatically indexed to this study by Identifier (NCT Number):
Responsible Party: Radboud University Identifier: NCT01773057     History of Changes
Other Study ID Numbers: NHGDoc 2012
Study First Received: November 22, 2012
Last Updated: May 6, 2015

Keywords provided by Radboud University:
Computerized Decision Support System
Heart failure
Effects on quality of care
Process of care
Patient outcomes

Additional relevant MeSH terms:
Heart Failure
Heart Diseases
Cardiovascular Diseases processed this record on May 25, 2017