The effectiveness of a multi-domain electronic feedback report on the performance of quality indicators for chronic conditions: Protocol for a randomized controlled trial in general practice

PLoS One. 2024 Nov 21;19(11):e0314360. doi: 10.1371/journal.pone.0314360. eCollection 2024.

Abstract

Background: Chronic conditions are a significant public health concern due to their rising prevalence, association with high mortality, and substantial healthcare costs. General practitioners play a crucial role in managing these conditions, and quality indicators are essential tools for assessing the quality of care. Electronic feedback reports incorporating quality indicator performance have shown promise in improving care quality. However, most studies have focused on single conditions or link feedback to financial incentives, which may not sustain long-term practice changes. This study aims to evaluate the effectiveness of a multi-condition electronic feedback reports on quality indicator performance in Swiss general practice without financial incentives.

Methods: This randomized controlled trial involves general practitioners enrolled in the FIRE project, a database of electronic medical records from Swiss primary care. Participants are randomized to receive either a plain feedback report or a comprehensive quality indicator -specific feedback report bi-monthly for 12 months. The plain feedback report contains descriptive summaries of practice activities, while the quality indicator-specific feedback report includes performance data on 14 quality indicators across cardiovascular, endocrine, pulmonary, and renal domains. The quality indicators were selected in multi-step process involving review of the literature and clinical guidelines, domain expert consultations, and a panel discussion with general practitioners. The primary study objective is to compare the effectiveness of the quality indicator-specific feedback report and of the plain feedback report with respect to the performance of the selected quality indicators.

Conclusion: The study addresses a critical gap by evaluating a multi-condition feedback report without financial incentives. Its findings can inform future health policies and strategies, in line with national and international initiatives that promote or even require the implementation of quality measurement activities in general practice.

Trial registration: Trial registry: ISRCTN. Registration number: ISRCTN10637092, https://www.isrctn.com/ISRCTN10637092. Registered January 9, 2024.

MeSH terms

  • Chronic Disease / therapy
  • Clinical Protocols
  • Electronic Health Records / standards
  • Feedback
  • General Practice* / standards
  • Humans
  • Quality Indicators, Health Care*
  • Randomized Controlled Trials as Topic / standards
  • Switzerland

Grants and funding

This study is supported by a grant from the Federal Quality Commission (FQC) c/o Federal Office of Public Health (FOPH), Bern, Switzerland (https://www.bag.admin.ch/bag/de/home/das-bag/organisation/ausserparlamentarische-kommissionen/eidgenoessische-qualitaetskommission-eqk.html, contract number 142005597, awarded to TR). The funder had no role in study design, data collection and analysis, preparation of the manuscript, and decision to publish.