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Effectiveness of a Public Campaign to Increase Stroke Awareness in Reducing Prehospital Delay

Not Applicable
Completed
Conditions
Acute Stroke
Interventions
Other: Educational campaign
Other: Usual care
Registration Number
NCT01881152
Lead Sponsor
Azienda Ospedaliero-Universitaria di Parma
Brief Summary

The starting hypothesis is that a multilevel educational campaign, specifically developed for the local community, can increase public stroke awareness and reduce pre-hospital delay.

The effectiveness of such intervention will be evaluated according to a cluster randomized, stepped wedged design. The clusters are the four communities of the Area Vasta Emilia Nord, AVEN (Parma, Piacenza, Modena e Reggio Emilia). As analysis Units, we will consider the patients consecutively admitted to the six participating hospitals throughout the study period, for suspected stroke or transitory ischemic attack (TIA).

Detailed Description

After a baseline 3 month period, the educational campaign will be sequentially launched in the four communities over four 3 month periods, according to a computer-generated list. The comparison will be the"usual care".

Primary outcome measures: The proportion of patients arriving at the Emergency Department (ED) with suspected stroke or TIA within two hours.

Secondary outcome measures: the proportion of patients with confirmed stroke or TIA diagnosis; the proportion of ischemic stroke patients evaluated for recominanat Tissue Plasminogen Activator (rTPA) therapy; the proportion of patients treated with rTPA; time interval between arrival at the ED and CT scan; for patients treated with rTPA, time interval between arrival at the ED and therapy initiation (door to needle time); death and disability (assessed as modified Rankin Score 3-5) at 1 and 3 month from stroke onset.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
1772
Inclusion Criteria
  • Patients consecutively admitted to the six participating hospitals for suspected stroke or transitory ischemic attack (TIA), defined as abrupt onset of focal or generalized neurologic deficit of vascular origin.
Exclusion Criteria
  • No information available on the time of stroke onset.
  • No informed consent from patient or caregiver

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
InterventionEducational campaignEducational campaign
ControlUsual careUsual care
Primary Outcome Measures
NameTimeMethod
Percentage of early admissionTime interval from stroke onset to arrival at the Emergency Department

Proportion of patients arriving to the Emergency Department with suspected stroke or TIA within two hours

Secondary Outcome Measures
NameTimeMethod
Poor outcome at 1 month1 month from stroke onset

Death or disability (modified Rankin Scale 3-6)at 1 month

Poor outcome at 3 months3 months from stroke onset

Death or disability (modified Rankin Scale 3-6) at 3 months

Rate of thrombolysisUp to 4 hours and 30 minutes from stroke onset

Proportion of patients given thrombolysis

Rate of thrombolysis activationUp to 3 hours from stroke onset

Proportion of patients evaluated for thrombolysis

Delay in CT scanUp to 12 hours from admission at the ED

Time interval between arrival at the Emergency Department and CT scan

Door to needle timeUp to 4 hours and 30 minutes from stroke onset

Time interval between arrival at the ED and thrombolysis initiation

Trial Locations

Locations (5)

University Hospital of Parma

🇮🇹

Parma, Italy

AUSL Parma

🇮🇹

Fidenza, Italy

Arcispedale Santa Maria Nuova of Reggio Emilia

🇮🇹

Reggio Emilia, Italy

Ospedale Civile S. Agostino Estense-Baggiovara-AUSL Modena

🇮🇹

Modena, Italy

Ospedale Guglielmo di Siliceto-AUSL Piacenza

🇮🇹

Piacenza, Italy

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