Quality Improvement in Stroke Prevention (QUISP)
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Purpose
Is a secondary prevention intervention, focused on implementation of standardized pre-printed discharge orders for hospitalists, effective at increasing utilization of the following evidence-based treatments 6 months after discharge for ischemic stroke:
- Treatment with statins,
- Control of hypertension, and
- Anticoagulation in patients with atrial fibrillation.
| Condition | Intervention | Phase |
|---|---|---|
|
Ischemic Stroke |
Drug: Optimal treatment |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety Study Intervention Model: Single Group Assignment Masking: Single Blind Primary Purpose: Prevention |
| Official Title: | Secondary Prevention After Ischemic Stroke: A Trial of an Evidence-Based System-Wide Intervention |
- Medication utilization
- Best Practices
- Recurrent stroke
- Mortality
- Morbidity
- Cost
- Hospital readmission
| Estimated Enrollment: | 1500 |
| Study Start Date: | December 2005 |
| Study Completion Date: | March 2007 |
There are several proven strategies for prevention of recurrent ischemic stroke, including use of statins, treatment of hypertension, and anticoagulation in patients with atrial fibrillation. Preliminary analyses suggest that only 9-15% of Kaiser Permanente Northern California’s ischemic stroke patients receive optimal care for secondary prevention of stroke. The purpose of this study is to determine whether or not a quality improvement (QI) intervention can improve the care received by stroke patients. This project consists of a randomized trial of standardized stroke discharge order forms to improve adherence with best practices in secondary stroke prevention. The primary research question is: Is a secondary prevention intervention, focused on implementation of standardized pre-printed discharge orders for hospitalists, effective at increasing utilization of the following evidence-based treatments 6 months after discharge for ischemic stroke: (1) treatment with statins, (2) control of hypertension, and (3) anticoagulation in patients with atrial fibrillation.
The primary outcome will be the proportion of patients receiving optimal treatment, as defined by these three goals. The impact of the intervention will be measures as a change after-to-before at intervention hospitals compared to non-intervention (control) hospitals, with the institution as the unit of analysis. Secondary analyses will evaluate the impact of the intervention on each of these components and on 6-month and 1-year rates of mortality, readmission for stroke, and costs of care after discharge.
Eligibility| Ages Eligible for Study: | 50 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Ischemic stroke Kaiser-Permanente Health Plan Member with Pharmacy Benefit Discharged alive to home
Exclusion Criteria:
tpA patients Hemorrhagic stroke TIA Significant comorbidities
Contacts and Locations| United States, California | |
| Kaiser-Permanente Division of Research | |
| Oakland, California, United States, 94612 | |
| Study Director: | David M Grosvenor, MPH | University of California, San Francisco |
| Principal Investigator: | S C Johnston, MD | University of California, San Francisco |
More Information
No publications provided by University of California, San Francisco
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| ClinicalTrials.gov Identifier: | NCT00328640 History of Changes |
| Other Study ID Numbers: | MM 0620 0404 |
| Study First Received: | May 18, 2006 |
| Last Updated: | April 25, 2007 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by University of California, San Francisco:
|
CVA Ischemic stroke |
Additional relevant MeSH terms:
|
Ischemia Stroke Cerebral Infarction Pathologic Processes Cerebrovascular Disorders Brain Diseases |
Central Nervous System Diseases Nervous System Diseases Vascular Diseases Cardiovascular Diseases Brain Infarction Brain Ischemia |
ClinicalTrials.gov processed this record on May 23, 2013