The goal of this clinical trial is to learn if a digital health app called DINKNESH is effective for palliative care identification compared to traditional paper-based assessment tools. It will also look at the factors that help or hinder the use of this app in primary care settings.
The main questions it aims to answer are:
Does the DINKNESH app improve palliative care assessments compared to paper forms?
What are the main barriers and facilitators for Health Extension Workers when using the app in their daily work?
We will compare the DINKNESH app to standard paper-based tools to see if digital tools improve clinical assessment and implementation.
Participants will:
Be assessed for palliative care needs using either the DINKNESH mobile app or standard paper forms.
Receive routine follow-up care as determined by their health provider.
(For health workers): Participate in interviews or surveys to discuss their experience using the assigned assessment tool.
Adults aged 18 years or older
Currently diagnosed with one or more chronic conditions and receiving home-based follow-up care from a participating Family Health Team within the catchment area of a selected study cluster
Willing to provide verbal informed consent, or has a primary caregiver willing to provide proxy consent
Staff members of the Family Health Team at the selected clusters
For patients
Patients whose clinical condition prevents both self-participation and proxy participation in the assessment process
Patients already formally identified and referred for palliative care prior to the study period
Staff members planning to be absent for more than 1 day during the six-week active study period
Parallel
DINKNESH App
Other interventionA mobile-based digital health application designed to support Family Health Teams in the systematic identification and assessment of patients with palliative care needs. The application digitizes validated clinical tools, including the Supportive and Palliative Care Indicators Tool (SPICT), the Eastern Cooperative Oncology Group (ECOG) performance status, and the Integrated Palliative care Outcome Scale (IPOS) along with reference materials
Paper based tool
Other interventionA paper-based clinical assessment protocol designed to support Family Health Teams in the systematic identification and assessment of patients with palliative care needs. It incorporates the same validated clinical tools used in the intervention arm, including the Supportive and Palliative Care Indicators Tool (SPICT), the Eastern Cooperative Oncology Group (ECOG) performance status, and the Integrated Palliative care Outcome Scale (IPOS), administered manually during routine home visits without the use of a digital application and reference material.
Rate of identification of patients with palliative care needs.
The primary outcome is the rate of palliative care identifications, calculated as the number of individuals identified as requiring palliative care divided by the total number of chronic patient visit conducted by the Family Health Teams during the study period.
Qualitative assessment of implementation barriers and enablers.
Evaluation of implementation determinants (barriers and facilitators) through focus group discussions with health extension workers
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This trial is not recruiting at the moment. You can still explore other options:
