@Article{信息:doi 10.2196 / / jmir。7421，作者=“Voruganti, Teja和Grunfeld, Eva和Jamieson, Trevor和Kurahashi, Allison M和Lokuge, Bhadra和Krzyzanowska, Monika K和Mamdani, Muhammad和Moineddin, Rahim和Husain, Amna”，标题=“我的团队的护理研究:基于web的沟通工具用于晚期癌症患者协作护理的试验随机对照试验”，期刊=“J Med Internet Res”，年=“2017”，月=“7月”，日=“18”，卷=“19”，数=“7”，页=“e219”，关键词=“MeSH:互联网;——关系;跨学科的交流;肿瘤;成年人;慢性疾病;病人护理的连续性;病人护理小组;沟通; outcome assessment (health care)", abstract="Background: The management of patients with complex care needs requires the expertise of health care providers from multiple settings and specialties. As such, there is a need for cross-setting, cross-disciplinary solutions that address deficits in communication and continuity of care. We have developed a Web-based tool for clinical collaboration, called Loop, which assembles the patient and care team in a virtual space for the purpose of facilitating communication around care management. Objective: The objectives of this pilot study were to evaluate the feasibility of integrating a tool like Loop into current care practices and to capture preliminary measures of the effect of Loop on continuity of care, quality of care, symptom distress, and health care utilization. Methods: We conducted an open-label pilot cluster randomized controlled trial allocating patients with advanced cancer (defined as stage III or IV disease) with ≥3 months prognosis, their participating health care team and caregivers to receive either the Loop intervention or usual care. Outcome data were collected from patients on a monthly basis for 3 months. Trial feasibility was measured with rate of uptake, as well as recruitment and system usage. The Picker Continuity of Care subscale, Palliative care Outcomes Scale, Edmonton Symptom Assessment Scale, and Ambulatory and Home Care Record were patient self-reported measures of continuity of care, quality of care, symptom distress, and health services utilization, respectively. We conducted a content analysis of messages posted on Loop to understand how the system was used. Results: Nineteen physicians (oncologists or palliative care physicians) were randomized to the intervention or control arms. One hundred twenty-seven of their patients with advanced cancer were approached and 48 patients enrolled. Of 24 patients in the intervention arm, 20 (83.3{\%}) registered onto Loop. In the intervention and control arms, 12 and 11 patients completed three months of follow-up, respectively. A mean of 1.2 (range: 0 to 4) additional healthcare providers with an average total of 3 healthcare providers participated per team. An unadjusted between-arm increase of +11.4 was observed on the Picker scale in favor of the intervention arm. Other measures showed negligible changes. Loop was primarily used for medical care management, symptom reporting, and appointment coordination. Conclusions: The results of this study show that implementation of Loop was feasible. It provides useful information for planning future studies further examining effectiveness and team collaboration. Numerically higher scores were observed for the Loop arm relative to the control arm with respect to continuity of care. Future work is required to understand the incentives and barriers to participation so that the implementation of tools like Loop can be optimized. Trial Registration: ClinicalTrials.gov NCT02372994; https://clinicaltrials.gov/ct2/show/NCT02372994 (Archived by WebCite at http://www.webcitation.org/6r00L4Skb). ", issn="1438-8871", doi="10.2196/jmir.7421", url="//www.mybigtv.com/2017/7/e219/", url="https://doi.org/10.2196/jmir.7421", url="http://www.ncbi.nlm.nih.gov/pubmed/28720558" }