Canadian Community Utilization of Stroke Prevention Study - Emergency Department
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 360
- 试验地点
- 5
- 主要终点
- New OAC Prescription (Phase 1 and 3 comparison)
研究概览
简要总结
Atrial fibrillation (AF) is a common heart condition, and increases the risk of stroke by six times. There are several medications (blood thinners) that can prevent strokes in AF patients. Many AF patients present to the emergency department, but about half of AF patients leave without prescription of a blood thinner. The study aims to evaluate if adding options like giving a patient education kit, encouraging emergency room physicians to prescribe a blood thinner and providing a specialized AF clinic to patients will increase the number patients receiving blood thinners to prevent strokes.
详细描述
This is a knowledge translation study will occur in three consecutive phases: Phase 1 is a retrospective chart review of all patients who presented to the emergency department (ED) with ECG documented AF during 1 year prior to study commencement. The main purpose of Phase 1 is to determine if oral anticoagulants (OACs) were prescribed for eligible AF patients at ED discharge. In Phase 2 a low-intensity intervention will be applied in the ED during 6 months, involving physician education, distribution of an AF patient education package, short-term OAC prescription, and a follow-up letter to the patient's family physician. After a one month transition phase, a high intensity intervention will be applied during 6 months in Phase 3. Phase 3 incorporates the Phase 2 intervention, and adds immediate follow-up (within 48-72 hours) in a community AF clinic run by a nurse/pharmacist who is supervised by a specialist in AF.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Single Group
- 主要目的
- Prevention
- 盲法
- None
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients who present to the emergency department with electrocardiographically documented atrial fibrillation on a 12 lead ECG
排除标准
- •Prosthetic or mechanical mitral or aortic valve
- •Known rheumatic heart disease
- •Unable to provide informed consent
- •Will be admitted to hospital
- •Life expectancy of < 6 months
- •Metastatic malignancy
结局指标
主要结局
New OAC Prescription (Phase 1 and 3 comparison)
时间窗: Up to 72 hrs
次要结局
- OAC use in eligible patients at 30 days (Phase 2 and 3 comparison)(30 days)
- OAC use in eligible patients at 6 months (Phase 2 and 3 comparison)(6 months)
- Uptake of study interventions(6 months)
- New OAC Prescription (Phase 1 and 2 comparison)(Up to 72 hrs)
- New OAC Prescription (Phase 2 and 3 comparison)(Up to 72 hrs)