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Quality Improvement in Stroke Prevention (QUISP)

NCT ID: NCT00328640

Last Updated: 2007-04-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

1500 participants

Study Classification

INTERVENTIONAL

Study Start Date

2005-12-31

Study Completion Date

2007-03-31

Brief Summary

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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.

Detailed Description

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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.

Conditions

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Ischemic Stroke

Keywords

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CVA Ischemic stroke

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Interventions

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Optimal treatment

Intervention Type DRUG

Eligibility Criteria

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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
Minimum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Kaiser Permanente

OTHER

Sponsor Role collaborator

University of California, San Francisco

OTHER

Sponsor Role lead

Principal Investigators

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David M Grosvenor, MPH

Role: STUDY_DIRECTOR

University of California, San Francisco

S C Johnston, MD

Role: PRINCIPAL_INVESTIGATOR

University of California, San Francisco

Locations

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Kaiser-Permanente Division of Research

Oakland, California, United States

Site Status

Countries

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United States

References

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Johnston SC, Sidney S, Hills NK, Grosvenor D, Klingman JG, Bernstein A, Levin E. Standardized discharge orders after stroke: results of the quality improvement in stroke prevention (QUISP) cluster randomized trial. Ann Neurol. 2010 May;67(5):579-89. doi: 10.1002/ana.22019.

Reference Type DERIVED
PMID: 20437555 (View on PubMed)

Other Identifiers

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MM 0620 0404

Identifier Type: -

Identifier Source: org_study_id