Condition category
Not Applicable
Date applied
Date assigned
Last edited
Retrospectively registered
Overall trial status
Recruitment status
No longer recruiting

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?
Peter Makai

Trial website

Contact information



Primary contact

Dr René Melis


Contact details

Post box 9101
Reinier Postlaan
Route 934
6500 HB
+31 (0)24 3616772

Additional identifiers

EudraCT number number

Protocol/serial number


Study information

Scientific title

A controlled clinical trial to evaluate the Health and Welfare Information Portal: improved information for and about frail elderly and their caregivers



Study hypothesis

ZWIP will lead to improved patient outcomes as compared to standard care.

Ethics approval

Radboud University Medical Centre Medical Ethics Council

Study design

Non-randomized controlled trial with before and after measurement

Primary study design


Secondary study design

Non randomised controlled trial

Trial setting

GP practices

Trial type

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.

Intervention type



Drug names

Primary outcome measure

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
8. Carer-Qol

Overall trial start date


Overall trial end date


Reason abandoned (if study stopped)


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.

Participant type


Age group




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
6500 HB

Sponsor information


ZonMw (Netherlands)

Sponsor details

Laan van Nieuw Oost Indië 334
Postbox 93 245
The Hague
2509 AE
+31 (0)70 349 51 11

Sponsor type

Research organisation



Funder type

Research organisation

Funder name

ZonMw (Netherlands)

Alternative name(s)

Netherlands Organisation for Health Research and Development

Funding Body Type

private sector organisation

Funding Body Subtype

other non-profit



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

Basic results (scientific)

Publication list

Publication citations

Additional files

Editorial Notes