Knowledge Translation for Patients With Acute Coronary Syndromes (AMI-OPTIMA)
Knowledge Translation to Promote Evidence-based Medical Therapy in Acute Coronary Syndromes
Studieöversikt
Status
Betingelser
Intervention / Behandling
Detaljerad beskrivning
The AMI-OPTIMA study was a cluster randomized controlled trial of 24 hospitals to one-year knowledge translation (KT) vs usual care. Prior to randomization, we reviewed charts of 100 consecutive acute coronary syndromes (ACS) patients at each participating hospital in 2009. During one year, hospitals randomized to KT completed: 1) revision of the most recent American Heart Association Guidelines of ACS management, 2) focus groups to identify and solve local care gaps, and 3)local champion team to promote evidence-based medical therapy (EBMT). At the end of 12-month of KT/usual care, we reviewed discharge prescriptions of 100 consecutive ACS patients at each participating hospital (year 2012).
EBMT was pre-defined as in-hospital anticoagulation and discharge prescription of dual anti-platelets, beta-blockers, statins, and angiotensin pathway modulating agents (for patients with impaired left ventricular systolic function). Refusal, impaired cognitive function, allergy or intolerance of patients to any of EBMT were considered valid reasons for withholding EBMT.
Studietyp
Inskrivning (Faktisk)
Fas
- Inte tillämpbar
Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
- Barn
- Vuxen
- Äldre vuxen
Tar emot friska volontärer
Kön som är behöriga för studier
Beskrivning
Inclusion Criteria:Had a final discharge diagnosis of one of the following categories:
- Myocardial infarction with ST-segment elevation
- Myocardial infarction without ST-segment elevation
- Unstable angina
- Acute coronary syndromes -
Exclusion Criteria:
- Non-atherosclerotic coronary artery disease (as confirmed by coronary angiograms or other non-invasive tests such as stress test, coronary CT-scan, nuclear scans)
- Hospital stay of less than 48 hours -
Studieplan
Hur är studien utformad?
Designdetaljer
- Tilldelning: Randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Ingen (Open Label)
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
|---|---|
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Inget ingripande: Vanlig skötsel
inget ingripande
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Experimentell: knowledge translation
knowledge translation 12-month multi-facet intensive knowledge translation measures that include: Community of practice, local gap analysis, opinion leaders, targeted interventions, performance feedback, reminders and local formation of ACS teams.
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knowledge translation that include: Community of practice, local gap analysis, opinion leaders, targeted interventions, performance feedback, reminders and local formation of ACS teams.
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Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
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Proportion of patients who received evidence-based medical therapy at hospital discharge (mean of 4 days)
Tidsram: at hospital discharge (average of 4 days)
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Evidence-based medical therapy is defined as aspirin,dual-antiplaquelets, beta-blockers, statins.
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at hospital discharge (average of 4 days)
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Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
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Discharge prescription of individual evidence-based medical therapy: aspirin, dual antiplatelets, beta-blockers
Tidsram: at hospital discharge (average of 4 days)
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For each of the following medication: aspirin, dual anti-platelet, beta-blocker and statin, we calculated the proportion of patients who were prescribed the specific medication at discharge (as recorded on the discharge prescription).
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at hospital discharge (average of 4 days)
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Safety endpoints (mortality, reinfarction, strokes and bleeding outcomes (TIMI major and minor bleeds))
Tidsram: in-hospital (average of 4 days)
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mortality, reinfarction, strokes and bleeding outcomes (TIMI major and minor bleeds)
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in-hospital (average of 4 days)
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Samarbetspartners och utredare
Sponsor
Samarbetspartners
Utredare
- Huvudutredare: thao huynh, md,msc,phd, Montreal General Hospital
Publikationer och användbara länkar
Allmänna publikationer
- Huynh T, Kouz S, Afilalo M, Rinfret S, Schampaert E, Mansour S, Montigny M, Eisenberg MJ, Lauzon C, Dery JP, Nguyen M, L'Allier P, Harvey R, Boudreault C, Tardif JC. Knowledge Translation to improve prescription of evidence-based medical therapy for patients admitted with acute coronary syndromes: insights from the AMI-OPTIMA study. Journal of the American College of Cardiology.J Am Coll Cardiol. 2015;65(10_S).
Studieavstämningsdatum
Studera stora datum
Studiestart
Primärt slutförande (Faktisk)
Avslutad studie (Faktisk)
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Uppskatta)
Uppdateringar av studier
Senaste uppdatering publicerad (Uppskatta)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Ytterligare relevanta MeSH-villkor
Andra studie-ID-nummer
- DIREG_L_04201
Plan för individuella deltagardata (IPD)
Planerar du att dela individuella deltagardata (IPD)?
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