Plain English Summary
Background and study aims
Frail elderly people often face considerable difficulties in navigating the healthcare system. Care is fragmented, with involvement from a constantly changing group of professionals from a variety of care settings. Because of this fragmentation, general practitioners, specialists, nurses and other professionals are frequently unaware of the fact that they provide care for the same patients. There needs to be better coordination between professionals through sharing information about the patients in order to improve their care. Intensive communication between the professionals, the patients and their caregivers is also necessary for shared decision-making and self-management, which lead to better patient outcomes. In order to realize such goals, professionals have to be aware of the patient’s goals, and they should be able to provide care in accordance with such goals. Elderly patients generally wish to be informed about their care and appreciate if they wishes are taken into account when decisions are made. Also, accurate and timely information is necessary for shared decision-making. However, with the current organization of care, patients often do not receive continuous care, engage in shared decision-making or practice self-management. For this reason interventions are being developed to address this problem. ZWIP is intended to facilitate both patients’ self-management and collaboration between professionals. ZWIP is a healthcare social-media network for frail older people, their caregivers and professionals. A main feature of ZWIP is that patients are central in the system - patients and their caregivers decide which professionals join their network, and professionals can exchange messages with the patients and each other. The aim of this study is to evaluate the effectiveness of ZWIP compared to standard care.
Who can participate?
Frail elderly patients aged over 70 living in the east of the Netherlands.
What does the study involve?
Participants in general practices using ZWIP are compared with participants in practices using standard care. Participants are assessed by questionnaire.
What are the possible benefits and risks of participating?
Patients can communicate with their professionals through ZWIP. There are no risks or side effects involved.
Where is the study run from?
The study is run from the Radboud University Medical Centre, and about 11 GP practices in the east of the Netherlands take part in the study.
When is the study starting and how long is it expected to run for?
January 2011 to December 2012.
Who is funding the study?
ZonMw, Netherlands Organization for Health Research and Development.
Who is the main contact?
Dr René Melis
Post box 9101
+31 (0)24 3616772
A controlled clinical trial to evaluate the Health and Welfare Information Portal: improved information for and about frail elderly and their caregivers
ZWIP will lead to improved patient outcomes as compared to standard care.
Radboud University Medical Centre Medical Ethics Council
Non-randomized controlled trial with before and after measurement
Primary study design
Secondary study design
Non randomised controlled trial
Quality of life
Patient information sheet
Frail elderly living at home
ZWIP is a complex intervention, intended to facilitate both patient's self-management and collaboration between professionals. ZWIP is a healthcare social-media network for multi-disciplinary communication for frail older people, their caregivers and professionals. The system registers patient goals and action plans which are associated with the goals in consultation with the patients. A main feature of the ZWIP is that patients are central in the system, patients and their caregivers decide which professionals join their network. Professionals can exchange messages with the patients and each other using ZWIP.
In the control group, frail elderly receive standard care.
Primary outcome measures
Katz-15 IADL, SF-36 social functioning, SF-36 psychological functioning after 1 year of usage
Secondary outcome measures
1. Patient and caregiver experience with being informed
2. Patient and caregiver experience with self-management
3. Patient and caregiver experience with co-decision making
4. Patient and caregiver experience with satisfaction with care
5. Emergency GP appointments
6. Unplanned hospitalization
7. Objective caregiver burden
Overall trial start date
Overall trial end date
Participant inclusion criteria
Frail elderly as identified by the EASYcare-Two step Older people Screening diagnostic instrument.
Development of an instrument for the identification of frail elderly as a target population for integrated care.
Target number of participants
642 vs. 402
Participant exclusion criteria
Does not meet inclusion criteria
Recruitment start date
Recruitment end date
Countries of recruitment
Trial participating centre
Post box 9101
Netherlands Organisation for Health Research and Development
Funding Body Type
private sector organisation
Funding Body Subtype
Results and Publications
Publication and dissemination plan
Not provided at time of registration
Intention to publish date
Participant level data
Not provided at time of registration
Results - basic reporting