The dissemination of consensus recommendations on the management of Canadian patients with non-variceal upper gastrointestinal bleeding: a national cluster randomised trial of a multifaceted tailored implementation strategy

AstraZeneca Canada Inc. (Canada)0 个研究点目标入组 2,024 人开始时间: 2008年8月13日最近更新: 2015年1月13日

适应症

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•Cluster-level inclusion criteria:
•Participating hospitals will be selected based on:
•1. A recognised level of prior patient accrual into one of the many registries we have carried out nationally in NVUGIB (RUGBE, REASON, and DURABLE - a national utilisation study of in-hospital acid suppressants, with over 8500 prescriptions)
•2. A minimum size of 75 beds required, with weekly hospitalisation of at least 4 - 5 patients with NVUGIB (data from site eligibility questionnaire and previous registries)
•3. The availability of a trained digestive endoscopist who can provide urgent gastroscopy within 24 (week-days) to 48 hours (week-ends) of presentation (availability of trained on-call endoscopy assistants not required since 60% of Canadian centres do not have one)
•4. Access to an in-house intensive care unit (ICU), and surgical support
•5. Existence of an institutional electronic pharmacy database
•Patient-level inclusion criteria:
•The charts of the patients will be included for:
•1. A patient aged 18 or over, either sex
•2. Patients treated during the study duration (or the baseline evaluation period)
•3. Primary or secondary discharge diagnoses of NVUGIB (per charted International Classification of Disease, 10th Revision [ICD-10] code). Additional confirmation of NVUGIB using patient symptoms will be done as previous.

•Patient-level exclusion criteria:
•The charts of patients will be excluded if:
•1. Patients were initially assessed at another institution for the present episode of NVUGIB and subsequently transferred to the participating site
•2. There was presentation with NVUGIB to an Emergency Room (ER) not requiring admission to hospital
•3. Endoscopy noted no gastro-duodenal ulcer bleeding, to ensure patient homogeneity

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