Quality Improvement in Stroke Prevention (QUISP)

This study has been completed.
Sponsor:
Collaborator:
Kaiser Permanente
Information provided by:
University of California, San Francisco
ClinicalTrials.gov Identifier:
NCT00328640
First received: May 18, 2006
Last updated: April 25, 2007
Last verified: April 2007
  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:

  1. Treatment with statins,
  2. Control of hypertension, and
  3. 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

Resource links provided by NLM:


Further study details as provided by University of California, San Francisco:

Primary Outcome Measures:
  • Medication utilization
  • Best Practices
  • Recurrent stroke

Secondary Outcome Measures:
  • Mortality
  • Morbidity
  • Cost
  • Hospital readmission

Estimated Enrollment: 1500
Study Start Date: December 2005
Study Completion Date: March 2007
Detailed Description:

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
Criteria

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
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00328640

Locations
United States, California
Kaiser-Permanente Division of Research
Oakland, California, United States, 94612
Sponsors and Collaborators
University of California, San Francisco
Kaiser Permanente
Investigators
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 July 23, 2014