A Randomized Trial Comparing "Push" Versus "Pull" Technology for Mobilizing Pain Evidence Into Practice Across Different Health Professions
調査の概要
詳細な説明
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.
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
-
-
Ontario
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Hamilton、Ontario、カナダ、L8S 1C7
- McMaster University
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
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
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:ヘルスサービス研究
- 割り当て:ランダム化
- 介入モデル:クロスオーバー割り当て
- マスキング:ダブル
武器と介入
参加者グループ / アーム |
介入・治療 |
---|---|
実験的: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.
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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.
|
プラセボコンパレーター: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.
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
Application of evidence (chart-stimulated recall)
時間枠: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
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Skill at accessing research evidence
時間枠:15 months
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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
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
Usage of PainPLUS
時間枠: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
時間枠: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
時間枠:0 months
|
0 months
|
協力者と研究者
スポンサー
捜査官
- 主任研究者:Joy MacDermid, PhD、McMaster University
出版物と役立つリンク
一般刊行物
- 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.
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
キーワード
その他の研究ID番号
- CIHR-228972
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。
痛みの臨床試験
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Dexa Medica Group完了
Push + Pullの臨床試験
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Ya-Wei XuWest China Hospital; Ruijin Hospital; Shanghai Ninth People's Hospital Affiliated to Shanghai... と他の協力者わからない脳卒中 | 非弁性心房細動
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Qmedics AGUniversity Hospital, Geneva; Erasmus Medical Center; University Hospital, Catania; Policlinico di... と他の協力者終了しました