None listed
Conditions
Brief summary
Non-valvular atrial fibrillation (NVAF) is a common heart condition associated with a major risk of fatal and disabling stroke. Inexpensive anticoagulant medication has been proven to reduce all-cases of death and stroke in people with NVAF. Anticoagulant treatment for NVAF is substantially underused resulting in avoidable patient deaths and disabling stroke. This study seeks to optimise the management of NVAF in general practice. We are developing an educational program for general practitioners which we hypothesis will increase the number of people with NVAF over the age of 65 who are prescribed anticoagulant medication.
Interventions
Despatch is a multifaceted, tailored educational intervention to redress noted barriers to the translation of best evidence into clinical practice relevant to the management of atrial fibrillation. Despatch will consist of the following components:
a) decisional support through a specifically created “Stop Stroke” specialist tele-service. b) Academic detailing: The “Stop-Stroke” members will include nurses with training in stroke medicine who will be employed as academic detailers. Academic de
Despatch is a multifaceted, tailored educational intervention to redress noted barriers to the translation of best evidence into clinical practice relevant to the management of atrial fibrillation. Despatch will consist of the following components: a) decisional support through a specifically created “Stop Stroke” specialist tele-service. b) Academic detailing: The “Stop-Stroke” members will include nurses with training in stroke medicine who will be employed as academic detailers. Academic detailing sessions will be delivered via three telephone sessions. c) GP, patient and practice decision tools The intervention will be delivered over a 12-month period after GP randomisation. Outcomes will be assessed using data collected from patient medical records.
Sponsors
NHMRC
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Educational / counselling / training
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
0 to No maximum
Healthy volunteers
No
Inclusion criteria
This is a cluster randomised controlled trial with general practices designated the unit of randomisation. Outcome measures will be assessed using patient data derived from medical records. Inclusion criteria: 1) GPs with a practice location within Sydney Metropolitan Area. 2) GPs must utilise an electronic data-base for issuing prescriptions and recording patient information (sex, age, contact details). Inclusion criteria for patients: 1) Aged older than 65 years 2) Ability to provide consent for medical record audit.
Exclusion criteria
Exclusion criteria for GPs: GPs engaged primarily in "special interest practice" with limited contact of elderly patients (> 65 years of age) will be considerd ineligible to participate. GPs in part-time practice (2 days a week or less) will initially be considered ineligible. However, this ineligibility criterion will be reviewed depending on the rate of recruitment of GPs and feasibility of recruitment.
Outcome results
None listed