Article Text

Original research
Patient information portal for congenital aortic and pulmonary valve disease: a stepped-wedge cluster randomised trial
  1. Jonathan R G Etnel1,
  2. Lidia R Bons2,
  3. Frederiek De Heer3,
  4. Daniëlle Robbers-Visser4,
  5. Ingrid M Van Beynum5,
  6. Bart Straver6,
  7. Monique RM Jongbloed7,
  8. Philippine Kiès7,
  9. Martijn G Slieker8,
  10. Arie P J Van Dijk9,
  11. Jolanda Kluin3,10,
  12. Robin A Bertels11,
  13. Elisabeth M W J Utens12,13,14,
  14. Regina The15,
  15. Eugene Van Galen16,
  16. Barbara J M Mulder4,
  17. Nico A Blom11,
  18. Mark G Hazekamp10,
  19. Jolien W Roos-Hesselink2,
  20. Willem A Helbing5,
  21. Ad J J C Bogers1 and
  22. Johanna J M Takkenberg1
  1. 1Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
  2. 2Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands
  3. 3Department of Cardiothoracic Surgery, Academic Medical Center, Amsterdam, Netherlands
  4. 4Department of Cardiology, Academic Medical Center, Amsterdam, Netherlands
  5. 5Department of Pediatric Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands
  6. 6Department of Pediatric Cardiology, Academic Medical Center, Amsterdam, Netherlands
  7. 7Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands
  8. 8Department of Pediatric Cardiology, Radboudumc, Nijmegen, Netherlands
  9. 9Department of Cardiology, Radboudumc, Nijmegen, Netherlands
  10. 10Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, Netherlands
  11. 11Department of Pediatric Cardiology, Leiden University Medical Center, Leiden, Netherlands
  12. 12Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, Netherlands
  13. 13Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands
  14. 14De Bascule, Academic Center for Child Psychiatry, Amsterdam, Netherlands
  15. 15ZorgKeuzeLab, Delft, Netherlands
  16. 16Patient Association ‘Patiëntenvereniging Aangeboren Hartafwijkingen’, Maarssen, Netherlands
  1. Correspondence to Dr Jonathan R G Etnel; j.etnel{at}erasmusmc.nl

Abstract

Background In response to an increased need for patient information in congenital heart disease, we previously developed an online, evidence-based information portal for patients with congenital aortic and pulmonary valve disease. To assess its effectiveness, a stepped-wedge cluster randomised trial was conducted.

Methods Adult patients and caregivers of paediatric patients with congenital aortic and/or pulmonary valve disease and/or tetralogy of Fallot who visited the outpatient clinic at any of the four participating centres in the Netherlands between 1 March 2016–1 July 2017 were prospectively included. The intervention (information portal) was introduced in the outpatient clinic according to a stepped-wedge randomised design. One month after outpatient clinic visit, each participant completed a questionnaire on disease-specific knowledge, anxiety, depression, mental quality of life, involvement and opinion/attitude concerning patient information and involvement.

Results 343 participants were included (221 control, 122 intervention). Cardiac diagnosis (p=0.873), educational level (p=0.153) and sex (p=0.603) were comparable between the two groups. All outcomes were comparable between groups in the intention-to-treat analyses. However, only 51.6% of subjects in the intervention group (n=63) reported actually visiting the portal. Among these subjects (as-treated), disease-specific knowledge (p=0.041) and mental health (p=0.039) were significantly better than in control subjects, while other baseline and outcome variables were comparable.

Conclusion Even after being invited by their cardiologists, only half of the participants actually visited the information portal. Only in those participants that actually visited the portal, knowledge of disease and mental health were significantly better. This underlines the importance of effective implementation of online evidence-based patient information portals in clinical practice.

  • congenital heart disease
  • clinical trials
  • quality of care and outcomes
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Supplementary materials

  • Supplementary Data

    This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.

Footnotes

  • Contributors All authors contributed to the planning, conduct, and reporting of the work described. JJMT is responsible for the overall content as guarantor.

  • Funding This work was supported by the Dutch Heart Foundation (2013T093).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study was approved by the institutional review board of the Erasmus University Medical Center (MEC-2015–584).

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Data availability statement Data are available on reasonable request.