TY - JOUR
T1 - An international cluster-randomized quality improvement trial to increase the adherence to evidence-based therapies for acute ischemic stroke and transient ischemic attack patients
T2 - Rationale and design of the BRIDGE STROKE Trial
AU - Machline-Carrion, Maria Julia
AU - Santucci, Eliana Vieira
AU - Damiani, Lucas Petri
AU - Bahit, Cecilia
AU - Málaga, Germán
AU - Pontes-Neto, Octávio Marques
AU - Martins, Sheila Cristina Ouriques
AU - Zétola, Viviane Flumignan
AU - Normilio-Silva, Karina
AU - de Freitas, Gabriel Rodrigues
AU - Gorgulho, Alessandra
AU - De Salles, Antônio
AU - da Silva, Beatriz Gonzales Pacheco
AU - Santos, Juliana Yamashita
AU - de Andrade Jesuíno, Isabella
AU - Bueno, Priscila Regina Torres
AU - Cavalcanti, Alexandre Biasi
AU - Guimarães, Hélio Penna
AU - Xian, Ying
AU - Bettger, Janet Prvu
AU - Lopes, Renato D.
AU - Peterson, Eric D.
AU - Berwanger, Otávio
N1 - Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2019/1
Y1 - 2019/1
N2 - Background: Translating evidence into clinical practice in the management of acute ischemic stroke (AIS) and transient ischemic attack (TIA) is challenging especially in low- and middle-income countries. Objectives: The aim of this study is to assess the effect of a multifaceted quality improvement intervention on adherence to evidence-based therapies for AIS and TIA patients care. Design: We designed a pragmatic, 2-arm cluster-randomized trial involving 36 clusters and 1624 patients from Brazil, Argentina, and Peru. Hospitals are randomized to receive a multifaceted quality improvement intervention (intervention group) or to routine care (control group). The BRIDGE Stroke multifaceted quality improvement intervention includes case management, reminders, health care providers’ educational materials (including treatment algorithms), interactive workshops, and audit and feedback reports. Primary outcome is a composite adherence score to AIS and TIA performance measures. Secondary outcomes include an “all or none” composite end point to performance measures, the individual components of the composite end points, and clinical outcomes at 90 days following admission (stroke recurrence, death, and disability measured by the modified Rankin scale). The BRIDGE Stroke Trial is an international pragmatic evaluation of a multifaceted quality improvement intervention. If effective, this intervention could be potentially extended widely to improve the quality of care and outcomes of patients with AIS or TIA.
AB - Background: Translating evidence into clinical practice in the management of acute ischemic stroke (AIS) and transient ischemic attack (TIA) is challenging especially in low- and middle-income countries. Objectives: The aim of this study is to assess the effect of a multifaceted quality improvement intervention on adherence to evidence-based therapies for AIS and TIA patients care. Design: We designed a pragmatic, 2-arm cluster-randomized trial involving 36 clusters and 1624 patients from Brazil, Argentina, and Peru. Hospitals are randomized to receive a multifaceted quality improvement intervention (intervention group) or to routine care (control group). The BRIDGE Stroke multifaceted quality improvement intervention includes case management, reminders, health care providers’ educational materials (including treatment algorithms), interactive workshops, and audit and feedback reports. Primary outcome is a composite adherence score to AIS and TIA performance measures. Secondary outcomes include an “all or none” composite end point to performance measures, the individual components of the composite end points, and clinical outcomes at 90 days following admission (stroke recurrence, death, and disability measured by the modified Rankin scale). The BRIDGE Stroke Trial is an international pragmatic evaluation of a multifaceted quality improvement intervention. If effective, this intervention could be potentially extended widely to improve the quality of care and outcomes of patients with AIS or TIA.
UR - http://www.scopus.com/inward/record.url?scp=85056165541&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85056165541&partnerID=8YFLogxK
U2 - 10.1016/j.ahj.2018.09.009
DO - 10.1016/j.ahj.2018.09.009
M3 - Article
C2 - 30415083
AN - SCOPUS:85056165541
SN - 0002-8703
VL - 207
SP - 49
EP - 57
JO - American heart journal
JF - American heart journal
ER -