TY - JOUR
T1 - The evaluation of a tailored intervention to improve the management of suspected viral encephalitis
T2 - Protocol for a cluster randomised controlled trial
AU - Backman, Ruth
AU - Foy, Robbie
AU - Diggle, Peter J.
AU - Kneen, Rachel
AU - Defres, Sylviane
AU - Michael, Benedict Daniel
AU - Medina-Lara, Antonieta
AU - Solomon, Tom
PY - 2015
Y1 - 2015
N2 - 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.
AB - 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.
KW - Cluster randomised controlled trial
KW - Encephalitis
KW - Guideline implementation
KW - Protocol
UR - http://www.scopus.com/inward/record.url?scp=84988729313&partnerID=8YFLogxK
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U2 - 10.1186/s13012-014-0201-1
DO - 10.1186/s13012-014-0201-1
M3 - Article
AN - SCOPUS:84988729313
SN - 1748-5908
VL - 10
JO - Implementation Science
JF - Implementation Science
IS - 1
M1 - 14
ER -