Ietje Perfors

57 Study outcomes The most often measured primary outcomes were healthcare utilization 16, 17, 23–25 and quality of life, 16–18, 25 as presented in table 2. Other outcomes consisted of patient and GP perceptions of care, symptoms, coping and empowerment. The following outcomes were not presented in the included articles: healthcare experience by informal caregivers and disease-specific outcomes (ie, progress, mortality). Outcomes are described in more detail below. Intervention fidelity/compliance and healthcare use Healthcare use is related to the uptake of the intervention. For example, if the intervention aims at more GP involvement, healthcare use is likely to increase. Although all interventions aimed at increased involvement of primary care, four interventions did not show a significant increase of GP consultations. 16, 19, 24, 25 Correspondingly, the uptake of interventions appeared to be low in the majority of the studies. This is illustrated by Bergholdt et al 19 which describes an ‘active involvement’ intervention, inwhich GP proactivity was comparable to GP proactivity in the control group (60% versus 52%, OR adjusted for sex and age 1.44 95%CI 0.80-2.36). 19 In two studies, information transfer to the GP by their patients was hardly used or remembered by the majority of the GPs. 24, 25 Five studies, evaluated the effect of the intervention onhospital and/or primary care resource use. These studies showed no significant effect on secondary care healthcare use. 23–25 Only the subgroup of older patients (≥70 years of age) had a significantly lower use of secondary care 23 when primary care was actively involved. Even though GP consultations where part of the interventions, several studies reported no difference in the number of GP consultations in the intervention group compared with the control group. 16, 17, 24–26 3