- ICH GCP
- US-Register für klinische Studien
- Klinische Studie NCT01348802
A Randomized Trial Comparing "Push" Versus "Pull" Technology for Mobilizing Pain Evidence Into Practice Across Different Health Professions
Studienübersicht
Status
Bedingungen
Intervention / Behandlung
Detaillierte Beschreibung
The Problem: Pain affects all Canadians during acute injury or disease. Chronic noncancer pain affects 29% of Canadians, half of whom are unable to participate in their usual work/social roles. Pain is the primary reason that patients consult health practitioners. Research has shown the benefits, harms, and costs of numerous interventions for pain, but uptake of this knowledge is far from satisfactory. Optimizing pain care requires ready access and use of best evidence within and across different disciplines and settings.
The Research Question: The purpose of this randomized trial is to determine whether a technology-based "push" of new, high-quality pain research to physicians, nurses, rehabilitation and psychology professionals results in better knowledge and clinical decision-making around pain, when offered in addition to traditional "pull" evidence technology. A secondary objective is to identify disciplinary variations in response to evidence and differences in the patterns of accessing research evidence.
The Study Sample: 670 Physicians, nurses, occupational/physical therapists and psychologists ((80/group X 2 comparison groups X 4 disciplines) + 30 for dropouts)will be recruited through professional associations, websites/conferences and social media. This provides > 90% power to detect main effects; 80% power for subgroup effects.
Outcome Measures: The primary outcomes are uptake and application of evidence. Uptake will be determined by embedded tracking of what research is accessed during use of the intervention. A random subset of 30 participants/discipline will undergo chart-stimulated recall (CSR) to assess the nature and depth of evidence utilization in actual case management (0, 9 months). A different random subset of 30 participants/discipline will be tested for their skills in accessing evidence using a standardized simulation test (final 3 months). Secondary outcomes include usage and self-reported evidence-based practice attitudes and behaviours (0, 3, 9, 15, 18 months).
Intervention/Methods: Participants who agree to this study of a free literature service will be randomly allocated to Push + Pull versus Pull evidence support. Push + Pull is evidence on pain that is extracted from medical, nursing and rehabilitation journals and appraised for quality and relevance and sent out to clinicians (derived from the successful MacPLUS/Evidence Updates), delivered by e-mail alerts or available for searches of the accumulated database). Pull will be an intervention with a similar front-face but requires clinicians to go to the site and extract evidence from an electronic database. The trial will begin with a 3-month (repeated) baseline, during which average participant use of the standard PULL resource will be monitored. Participants will then be randomly allocated to receive PUSH + PULL or continue to use the PULL resource. After six months, participants will cross over to the alternate intervention for an additional six months. To complete the trial, both groups will finish with three months of PUSH + PULL access.
Analyses: The investigators will use an analysis of covariance (ANCOVA), where discipline and setting are covariates to assess differential responses across main effects of Push + Pull vs. Pull. Content analysis of the CSR interview will be use to describe the application of evidence within actual cases.
Impact/Timeliness: The trial will inform our understanding on information preferences and behaviours across disciplines/practice settings. If this intervention is effective, sustained support will come through professional/health system initiatives emerging to optimize pain management in Canada.
Studientyp
Einschreibung (Tatsächlich)
Phase
- Unzutreffend
Kontakte und Standorte
Studienorte
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Ontario
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Hamilton, Ontario, Kanada, L8S 1C7
- McMaster University
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-
Teilnahmekriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Beschreibung
Inclusion Criteria:
- licensed physicians, nurses, occupational therapists (OT), physical therapists (PT), or psychologists who see patients at least 1 day/week;
- fluent in English;
- have access to a computer at home or at work which has unrestricted access to the World Wide Web,
- have an active email account
Exclusion Criteria:
- currently participating in other knowledge translation interventions
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Versorgungsforschung
- Zuteilung: Zufällig
- Interventionsmodell: Crossover-Aufgabe
- Maskierung: Doppelt
Waffen und Interventionen
Teilnehmergruppe / Arm |
Intervention / Behandlung |
---|---|
Experimental: Push + Pull
Push + Pull is evidence on pain that is extracted from medical, nursing, psychology and rehabilitation journals, appraised for quality and relevance, and delivered to clinicians by e-mail alerts or available for searches of the accumulated database.
|
Push + Pull is evidence on pain that is extracted from medical, nursing, psychology and rehabilitation journals, appraised for quality and relevance, and delivered to clinicians by e-mail alerts or available for searches of the accumulated database.
|
Placebo-Komparator: Pull
Pull will be an intervention with a similar front-face but requires clinicians to go to the site and extract evidence from an electronic database.
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Pull will be an intervention with a similar front-face but requires clinicians to go to the site and extract evidence from an electronic database.
|
Was misst die Studie?
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
---|---|---|
Application of evidence (chart-stimulated recall)
Zeitfenster: 0, 9 months
|
A random subset of 30 participants/discipline will undergo chart-stimulated recall to assess the nature and depth of evidence utilization in actual case management.
|
0, 9 months
|
Skill at accessing research evidence
Zeitfenster: 15 months
|
A different random subset of 30 participants/discipline will be tested for their skills in accessing evidence using a standardized simulation test.
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15 months
|
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
---|---|---|
Usage of PainPLUS
Zeitfenster: Every month
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Embedded tracking of number/frequency of article access and type of evidence.
Level of satisfaction with PainPLUS
|
Every month
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Attitudes about Evidence-Based Practice Questionnaire
Zeitfenster: 0, 3, 9, 15, and 18 months
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Knowledge/Attitude/Behaviour Questionnaire
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0, 3, 9, 15, and 18 months
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Familiarity/Access to Technology
Zeitfenster: 0 months
|
0 months
|
Mitarbeiter und Ermittler
Sponsor
Mitarbeiter
Ermittler
- Hauptermittler: Joy MacDermid, PhD, McMaster University
Publikationen und hilfreiche Links
Allgemeine Veröffentlichungen
- MacDermid JC, Law M, Buckley N, Haynes RB. "Push" versus "Pull" for mobilizing pain evidence into practice across different health professions: a protocol for a randomized trial. Implement Sci. 2012 Nov 24;7:115. doi: 10.1186/1748-5908-7-115.
- Arumugam V, MacDermid JC, Walton D, Grewal R. The yield and usefulness of PAIN+ and PubMed databases for accessing research evidence on pain management: a randomized crossover trial. Arch Physiother. 2021 Apr 1;11(1):9. doi: 10.1186/s40945-021-00100-7.
Nützliche Links
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn
Primärer Abschluss (Tatsächlich)
Studienabschluss (Tatsächlich)
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Schätzen)
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Schätzen)
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Andere Studien-ID-Nummern
- CIHR-228972
Diese Informationen wurden ohne Änderungen direkt von der Website clinicaltrials.gov abgerufen. Wenn Sie Ihre Studiendaten ändern, entfernen oder aktualisieren möchten, wenden Sie sich bitte an register@clinicaltrials.gov. Sobald eine Änderung auf clinicaltrials.gov implementiert wird, wird diese automatisch auch auf unserer Website aktualisiert .
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