Artikel
Surveillance and care for confirmed and suspected patients with COVID-19 in general practice (CovidCare): an observational trial
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Veröffentlicht: | 27. September 2021 |
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Background: COVID-19 manifests in an enormous variability in symptoms. While patients with severe symptoms are treated in hospitals, primary care practices remain responsible for most patients. However, providing structured care of affected patients in domestic isolation is associated with uncertainties and represents a challenge for primary care, especially for high-risk patients. To counter this and enable tailored care for COVID-19 patients in primary care, we designed a COVID-19 surveillance and care tool (CovidCare), which supports the primary care practice to monitor and manage high-risk COVID-19 patients. It facilitates a structured collection of symptoms including an initial assessment of yet known risk factors and continuous telephone monitorings of symptoms to identify a worse course of the disease. We aim to identify predictors of the course of COVID-19 to improve healthcare for affected high-risk patients and contribute to a more comprehensive knowledge in the field of health services research. The accompanying process evaluation investigates the utilization of CovidCare and the perspective of primary care staff and patients. The study was registered with the German Clinical Trials Register DRKS00022054, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00022054.
Research question: Data from a COVID-19 surveillance and care tool used in primary care practices to support care for high-risk patients are analyzed to gain a comprehensive understanding of risk factors, symptoms and courses of COVID-19. The feasibility and acceptability of users and patients will also be explored.
Methods: We will conduct a multi-centered prospective, longitudinal non-controlled, mixed-methods observational trial of COVID-19 patients in primary care. Overall, 700 practices who participate in general-practice centered care by the AOK Baden-Württemberg will be invited to participate, including adult COVID-19 patients (or urgent suspicion + ≥ 50 years) with at least one additional known risk factor, who participate in general-practice centered care. Data on symptoms and risks collected from the CovidCare tool will be analyzed descriptively. The primary outcome is hospitalization due to COVID-19. Secondary outcomes are the identification of predictive risk factors and frequencies. The process evaluation is based on interviews from primary care staff and patients and will be analyzed descriptively. The results will be used to further tailor CovidCare to the needs of primary care practices and patients.
Results: Preliminary results on risks, symptoms and outcomes will be expected in July 2021 and will be updated regularly. Symptoms and risk factors on the course of the disease will be reported and enable a more comprehensive understanding of COVID-19 and its treatment. According to the ongoing process evaluation, CovidCare allows to monitor the course of COVID-19, individually tailor the treatment as soon as symptoms worsen and encourage the provision of structured care.
Discussion: The results can be used for a better primary care management of COVID-19 and for the treatment of affected high-risk patients.
Practical implication: The CovidCare tool facilitates a structured support of COVID-19 patients in domestic isolation and enables the collection of health services research data.