General practice Research Infrastructure Pandemic Preparedness Program (GRIP3)

The COVID-19 pandemic has had major consequences for the Dutch population. General practitioners saw many patients with acute complaints due to COVID-19, but it is currently unclear which early drug treatments prevent a complicated disease course. In this proposal, the eight Dutch departments of general medicine and Nivel join forces from the General Practice Research Consortium. In close consultation with patient representatives and other stakeholders, they are developing three studies (work packages) regarding COVID-19 care by general practitioner care. In addition, the Consortium will also conduct research aimed at improving the facilities and preconditions for carrying out general practice research. Goal The aim of the 3 work packages focused on COVID-19 is to provide better scientific substantiation for the home treatment of COVID-19 by general practitioner care. The aim of the modules in the fourth 'infrastructure' work package is to support general practitioners and patients to participate in clinical and scientific research in order to also collect reliable data about treatments outside the hospital, to make it easier for general practitioners and patients. to participate in scientific research and to provide reliable research data more quickly in the event of future pandemics. Background During the beginning of the pandemic, due to the acute situation and unfamiliarity with treatment options, care for COVID-19 patients mainly took place in the hospital and was mainly referred from primary care in case of serious complaints. As more became known about treatment options, these were also increasingly applied by general practitioners to positively influence the course of the infection to prevent hospital admission. Facilities to investigate the effects of treatments and the course of the disease are necessary. There are also opportunities in the field of remote care and the application of more complex care in the home situation. Research is important to clarify and transfer the preconditions for contributing to safe and high-quality care at home. Research design In work package 1, the consortium uses nine large registration databases of routine care data from general practices to look at 1) the treatments used with medicines prescribed by general practitioners during the first COVID-19 waves in the Netherlands and 2) how often long COVID (long-term complaints after a COVID-19 infection) and which processes these patients go through with which results. In a national study in which a group of patients who receive a promising medicine is compared with a group of patients who do not receive the drug, the PRINCIPLE-NL trial is in line with a British study into the effect of promising medicines on the course of COVID-19 infection in risk groups (work package 2) in general practitioner care. The Covidtherapy@home study (work package 3) investigates whether home treatment tailored to the patient with oxygen support, anti-inflammatory dexamethasone and blood thinners is equivalent and safe for seriously ill COVID-19 patients compared to hospital admission. In addition to these COVID-19 work packages, the General Practice Research Consortium will set up several processes to significantly improve the infrastructure for general practice research in the Netherlands. The 3 work packages will be carried out in the first two years of the project. The next two years will be devoted to consolidating the infrastructure. Executive parties General Practice Consortium University Medical Center Groningen, Maastricht University, Leiden University Medical Center, Radboudumc, University Medical Center Utrecht, Amsterdam UMC - location AMC, Amsterdam UMC - location VUmc, Erasmus MC and Nivel. Collaboration partners ExpertDoc, ZorgDomein, Dutch Society of General Practitioners, C-support, Zorgbelang Inclusief, Institute for Responsible Use of Medicines, Personal Health Train