Knowledge Translation for Patients With Acute Coronary Syndromes (AMI-OPTIMA)
|ClinicalTrials.gov Identifier: NCT02672137|
Recruitment Status : Completed
First Posted : February 3, 2016
Last Update Posted : February 3, 2016
|Condition or disease||Intervention/treatment||Phase|
|Acute Coronary Syndromes||Behavioral: knowledge translation||Not Applicable|
The AMI-OPTIMA study was a cluster randomized controlled trial of 24 hospitals to one-year knowledge translation (KT) vs usual care. Prior to randomization, we reviewed charts of 100 consecutive acute coronary syndromes (ACS) patients at each participating hospital in 2009. During one year, hospitals randomized to KT completed: 1) revision of the most recent American Heart Association Guidelines of ACS management, 2) focus groups to identify and solve local care gaps, and 3)local champion team to promote evidence-based medical therapy (EBMT). At the end of 12-month of KT/usual care, we reviewed discharge prescriptions of 100 consecutive ACS patients at each participating hospital (year 2012).
EBMT was pre-defined as in-hospital anticoagulation and discharge prescription of dual anti-platelets, beta-blockers, statins, and angiotensin pathway modulating agents (for patients with impaired left ventricular systolic function). Refusal, impaired cognitive function, allergy or intolerance of patients to any of EBMT were considered valid reasons for withholding EBMT.
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||4604 participants|
|Intervention Model:||Parallel Assignment|
|Masking:||None (Open Label)|
|Official Title:||Knowledge Translation to Promote Evidence-based Medical Therapy in Acute Coronary Syndromes|
|Study Start Date :||January 2010|
|Actual Primary Completion Date :||December 2015|
|Actual Study Completion Date :||January 2016|
Experimental: knowledge translation
knowledge translation 12-month multi-facet intensive knowledge translation measures that include: Community of practice, local gap analysis, opinion leaders, targeted interventions, performance feedback, reminders and local formation of ACS teams.
Behavioral: knowledge translation
knowledge translation that include: Community of practice, local gap analysis, opinion leaders, targeted interventions, performance feedback, reminders and local formation of ACS teams.
No Intervention: Usual care
- Proportion of patients who received evidence-based medical therapy at hospital discharge (mean of 4 days) [ Time Frame: at hospital discharge (average of 4 days) ]Evidence-based medical therapy is defined as aspirin,dual-antiplaquelets, beta-blockers, statins.
- Discharge prescription of individual evidence-based medical therapy: aspirin, dual antiplatelets, beta-blockers [ Time Frame: at hospital discharge (average of 4 days) ]For each of the following medication: aspirin, dual anti-platelet, beta-blocker and statin, we calculated the proportion of patients who were prescribed the specific medication at discharge (as recorded on the discharge prescription).
- Safety endpoints (mortality, reinfarction, strokes and bleeding outcomes (TIMI major and minor bleeds)) [ Time Frame: in-hospital (average of 4 days) ]mortality, reinfarction, strokes and bleeding outcomes (TIMI major and minor bleeds)
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02672137
|Principal Investigator:||thao huynh, md,msc,phd||Montreal General Hospital|