Clinical Trial: A Cluster Controlled Trial Comparing Three Methods of Disseminating Practice Guidelines for Children With Croup

Study Status: Terminated
Recruit Status: Terminated
Study Type: Interventional

Official Title: A Cluster Controlled Trial Comparing Three Methods of Disseminating Practice

Brief Summary: The purpose of this study is to identify, from a societal perspective, the costs and associated benefits of three strategies for disseminating and implementing a practice guideline that addresses the management of croup.

Detailed Summary:

Overall Aim: The overall aim of this study is to identify - from a societal perspective - the costs and associated benefits of three strategies for implementing a practice guideline that addresses the management of croup.

Intervention Strategies: The intervention strategies to be compared will be mailing of printed educational materials (the "Standard intervention"), mailing plus a combination of interactive educational meetings, educational outreach visits, and reminders (a "Saturn intervention"), and a combination of mailing, interactive sessions, outreach visits, reminders plus identification of local opinion leaders and establishment of local consensus processes (a "Cadillac intervention").

Primary Objective: To determine which of the three intervention strategies are most effective at lowering the rate of hospital days per 1,000 disease episodes. The null hypothesis is that none of the intervention strategies reduce hospital utilization rates from baseline. The alternate hypothesis is that the intervention strategies will have a graded degree of effect on hospitalization rates, with the 'Standard intervention' having minimal to no effect, the 'Saturn intervention' having moderate but significant effect, and the 'Cadillac intervention' having the greatest effect.

Secondary Objective: To determine which of the three dissemination strategies are most effective at increasing the use of therapies of known benefit.

Economic Analysis: To determine which of the three intervention strategies will most effectively reduce total societal costs including all health care costs, costs borne by the family, and costs stemming from the strategies for disseminating guidelines.

Same as current

Current Secondary Outcome:

  • Proportion of patients treated in the ED and hospital with a corticosteroid.
  • Proportion of patients evaluated in ED for at least three hours after treatment with corticosteroids before the decision to admit to hospital is made.
  • Time to treatment with corticosteroids in both ED and hospital patients.
  • An economic analysis conducted from a societal perspective with costs classified as either payer (costs born by the province) or non-payer (costs born by individuals or the families of children with croup).


Original Secondary Outcome: Same as current

Information By: University of Calgary

Dates:
Date Received: September 2, 2005
Date Started: September 2000
Date Completion: March 2006
Last Updated: November 28, 2005
Last Verified: September 2005