The evaluation of a tailored intervention to improve the management of suspected viral encephalitis: Protocol for a cluster randomised controlled trial

Ruth Backman, Robbie Foy, Peter J. Diggle, Rachel Kneen, Sylviane Defres, Benedict Daniel Michael, Antonieta Medina-Lara, Tom Solomon

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Viral encephalitis is a devastating condition for which delayed treatment is associated with increased morbidity and mortality. Clinical audits indicate substantial scope for improved detection and treatment. Improvement strategies should ideally be tailored according to identified needs and barriers to change. The aim of the study is to evaluate the effectiveness and cost-effectiveness of a tailored intervention to improve the secondary care management of suspected encephalitis. Methods/Design: The study is a two-arm cluster randomised controlled trial with allocation by postgraduate deanery. Participants were identified from 24 hospitals nested within 12 postgraduate deaneries in the United Kingdom (UK). We developed a multifaceted intervention package including core and flexible components with embedded behaviour change techniques selected on the basis of identified needs and barriers to change. The primary outcome will be a composite of the proportion of patients with suspected encephalitis receiving timely and appropriate diagnostic lumbar puncture within 12 h of hospital admission and aciclovir treatment within 6 h. We will gather outcome data pre-intervention and up to 12 months post-intervention from patient records. Statistical analysis at the cluster level will be blind to allocation. An economic evaluation will estimate intervention cost-effectiveness from the health service perspective. Trial registration: Controlled Trials: ISRCTN06886935.

Original languageEnglish (US)
Article number14
JournalImplementation Science
Volume10
Issue number1
DOIs
StatePublished - 2015
Externally publishedYes

Keywords

  • Cluster randomised controlled trial
  • Encephalitis
  • Guideline implementation
  • Protocol

ASJC Scopus subject areas

  • Medicine(all)
  • Health Policy
  • Health Informatics
  • Public Health, Environmental and Occupational Health

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