دورية أكاديمية
Thrombolysis ImPlementation in Stroke (TIPS): Evaluating the effectiveness of a strategy to increase the adoption of best evidence practice - protocol for a cluster randomised controlled trial in acute stroke care
| العنوان: | Thrombolysis ImPlementation in Stroke (TIPS): Evaluating the effectiveness of a strategy to increase the adoption of best evidence practice - protocol for a cluster randomised controlled trial in acute stroke care |
|---|---|
| المؤلفون: | Paul, CL, Levi, CR, D'Este, CA, Parsons, MW, Bladin, CF, Lindley, RI, Attia, JR, Henskens, F, Lalor, E, Longworth, M, Middleton, S, Ryan, A, Kerr, E, Sanson-Fisher, RW, Anderson, C, Bruce, I, Buchan, H, Burdusel, C, Butler, E, Cadigan, G, Campbell, Z, Coles, T, Corbett, A, Day, S, Denisenko, S, Dennett, J, Dewey, H, Donnan, G, Doughty, M, Evans, M, Gearon, F, Geraghty, R, Gerraty, R, Gounden, S, Grady, A, Grimley, R, Grimshaw, J, Hankey, GJ, Hill, K, Hoffman, K, Huckson, S, Hughes, J, Jayakody, A, Jenkins, B, Jude, M, Kanard, M, Kinchington, M, Krause, M, Kuhle, S, Laird, P, Lee, A, Levy, S, Longworth, K, Macdonald, B, Mackey, E, Mandaleson, K, Mohr, K, Moore, S, Morris, K, O'Brien, E, Paddock, B, Parrey, K, Peake, R, Pollack, M, Price, C, Rose, S, Rupasinghe, J, Ryan, F, Searles, A, Smits, R, Stevenson, M, Taneja, S, Terpening, Z, Teasdale, N, Watson, J, Wilson, A, Weiner, Y, Wijeratne, T, Wolfe, N |
| المصدر: | urn:ISSN:1748-5908 ; Implementation Science, 9, 1, 38 |
| بيانات النشر: | Published by BioMed Central Ltd. |
| سنة النشر: | 2014 |
| المجموعة: | UNSW Sydney (The University of New South Wales): UNSWorks |
| مصطلحات موضوعية: | Hematology, Brain Disorders, Stroke, Clinical Research, Clinical Trials and Supportive Activities, Comparative Effectiveness Research, Aspirin, Australia, Cooperative Behavior, Diffusion of Innovation, Emergency Medical Services, Evidence-Based Medicine, Fibrinolytic Agents, Guideline Adherence, Humans, Patient Care Team, Practice Guidelines as Topic, Quality of Health Care, Research Design, Thrombolytic Therapy, Tissue Plasminogen Activator, Triage, Thrombolysis ImPlementation in Stroke (TIPS) Study Group, anzsrc-for: 08 Information and Computing Sciences, anzsrc-for: 11 Medical and Health Sciences |
| الوصف: | Background: Stroke is a leading cause of death and disability internationally. One of the three effective interventions in the acute phase of stroke care is thrombolytic therapy with tissue plasminogen activator (tPA), if given within 4.5 hours of onset to appropriate cases of ischaemic stroke.Objectives: To test the effectiveness of a multi-component multidisciplinary collaborative approach compared to usual care as a strategy for increasing thrombolysis rates for all stroke patients at intervention hospitals, while maintaining accepted benchmarks for low rates of intracranial haemorrhage and high rates of functional outcomes for both groups at three months.Methods and design: A cluster randomised controlled trial of 20 hospitals across 3 Australian states with 2 groups: multi- component multidisciplinary collaborative intervention as the experimental group and usual care as the control group. The intervention is based on behavioural theory and analysis of the steps, roles and barriers relating to rapid assessment for thrombolysis eligibility; it involves a comprehensive range of strategies addressing individual-level and system-level change at each site. The primary outcome is the difference in tPA rates between the two groups post-intervention. The secondary outcome is the proportion of tPA treated patients in both groups with good functional outcomes (modified Rankin Score (mRS <2) and the proportion with intracranial haemorrhage (mRS ≥2), compared to international benchmarks.Discussion: TIPS will trial a comprehensive, multi-component and multidisciplinary collaborative approach to improving thrombolysis rates at multiple sites. The trial has the potential to identify methods for optimal care which can be implemented for stroke patients during the acute phase. Study findings will include barriers and solutions to effective thrombolysis implementation and trial outcomes will be published whether significant or not.Trial registration: Australian New Zealand Clinical Trials Registry: ACTRN12613000939796. © ... |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | unknown |
| العلاقة: | http://hdl.handle.net/1959.4/unsworks_77700Test; https://unsworks.unsw.edu.au/bitstreams/1cd92253-bcf7-4a94-a1f1-dddd17791301/downloadTest; https://doi.org/10.1186/1748-5908-9-38Test |
| DOI: | 10.1186/1748-5908-9-38 |
| الإتاحة: | https://doi.org/10.1186/1748-5908-9-38Test http://hdl.handle.net/1959.4/unsworks_77700Test https://unsworks.unsw.edu.au/bitstreams/1cd92253-bcf7-4a94-a1f1-dddd17791301/downloadTest |
| حقوق: | open access ; https://purl.org/coar/access_right/c_abf2Test ; CC BY ; https://creativecommons.org/licenses/by/4.0Test/ ; free_to_read ; This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0Test), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
| رقم الانضمام: | edsbas.EC309D30 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1186/1748-5908-9-38 |
|---|