DTO-FTO trial: Small group quality improvement on prescribing and test ordering performance of general practitioners: a large scale implementation study in the South of the Netherlands

ISRCTN	ISRCTN40008171
DOI	https://doi.org/10.1186/ISRCTN40008171
Protocol serial number	NTR1033
Sponsor	University Maastricht (UM) (Netherlands)
Funders	CZ Health Insurance Company (CZ Actief in Gezondheid) (Netherlands), The Netherlands Organisation for Health Research and Development (ZonMw) (Netherlands)

Submission date: 23/08/2007
Registration date: 23/08/2007
Last edited: 18/04/2017

Recruitment status: No longer recruiting
Overall study status: Completed
Condition category: Other

Prospectively registered

Protocol

Statistical analysis plan

Results

Individual participant data

Plain English summary of protocol

Not provided at time of registration

Contact information

Mr J P Trietsch
Scientific

Maastricht University
Department of General Practice
P.O. Box 616
Maastricht
6200 MD
Netherlands

Phone	+31 (0)43 388 2877
Email	Jasper.Trietsch@HAG.unimaas.nl

Study information

Primary study design	Interventional
Study design	Multicentre cluster-randomised active-controlled parallel-group trial
Secondary study design	Cluster randomised trial
Study type	Participant information sheet
Scientific title	DTO-FTO trial: Small group quality improvement on prescribing and test ordering performance of general practitioners: a large scale implementation study in the South of the Netherlands
Study objectives	This strategy will improve the number of tests ordered or the volume of prescribed drugs by 20% and decrease the inter-doctor variation.
Ethics approval(s)	Ethics Board of the academic hospital Maastricht (azM)/Maastricht University (UM), 24/08/2006, ref: MEC 06-4-033
Health condition(s) or problem(s) studied	Prescribing and test ordering performance of general practitioners
Intervention	All participating GP's receive feedback on their own test ordering and prescribing performance in the foregoing six months on a predefined clinical topic. The graphical comparative feedback is send to each GP individually together with an outline of current guidelines on the topic, prior to the group meeting. The feedback will lead to peer review, seeking and discussing explanations for differences, comparing own performance to the guidelines, discussing a plan for change and discussing barriers to change. Each group discusses three clinical topics in six sessions. If the group wishes to do so, two sessions (test ordering and prescribing) can be combined into one session. The intervention will run from September 2007 through February 2009. Please note that as of 05/10/2007, the anticipated start date of this trial was posponed from September 2007 to December 2007.
Intervention type	Other
Primary outcome measure(s)	1. The volume of ordered diagnostic tests and of prescribed medication 2. The inter-doctor variation in both test ordering and prescribing Outcomes are measured at start of study (baseline), each 6 months preliminary data, after 18 months main timepoint for effect measurement, 6 and 12 months later long term effect measurement.
Key secondary outcome measure(s)	1. The quality of prescribing as defined by indicators 2. The level of functioning of the groups 3. What are the costs of implementation of the strategy? 4. Process data (attendance, altering of the meeting structure etc.) Outcomes are measured at start of study (baseline), each 6 months preliminary data, after 18 months main timepoint for effect measurement, 6 and 12 months later long term effect measurement.
Completion date	01/02/2010

Eligibility

Participant type(s)	Health professional
Age group	Adult
Sex	All
Target sample size at registration	50
Key inclusion criteria	Groups of General Practitioners (GPs) conjoint in pharmacotherapeutic audit groups.
Key exclusion criteria	1. Groups of over 15 GP's 2. Groups outside the provinces: Zeeland, Brabant or Limburg
Date of first enrolment	01/12/2007
Date of final enrolment	01/02/2010

Locations

Countries of recruitment

Netherlands

Study participating centre

Maastricht University

Maastricht
6200 MD
Netherlands

Results and Publications

Individual participant data (IPD) Intention to share	No
IPD sharing plan summary	Not provided at time of registration
IPD sharing plan

Study outputs

Output type	Details	Date created	Date added	Peer reviewed?	Patient-facing?
Results article	results	13/04/2017		Yes	No
Participant information sheet	Participant information sheet	11/11/2025	11/11/2025	No	Yes

Editorial Notes

18/04/2017: Publication reference added.