Peptic Ulcer Hemorrhage
Conditions
Keywords
peptic ulcer bleeding, upper GI hemorrhage, adherence to guidelines, knowledge transfer
Brief summary
The purpose of this study is to assess whether adherence to NVUGIB guidelines is improved with implementation of a national, tailored multifaceted intervention. Outcomes include adherence rates to two key endoscopic and pharmacological therapy guidelines together (primary), or adherence to these individually as well as to other recommendations (secondary). Patient outcomes and economic data are also assessed (tertiary).
Detailed description
Clusters are randomized to receive a published algorithm and guidelines (control group), or a multifaceted, tailored educational intervention (see details in protocol - intervention group). The charts of treated patients with non variceal upper GI bleeding are reviewed and adherence to selected guidelines recorded.
Interventions
OTHEREducational intervention
As per detailed protocol.
Sponsors
Horizon Health Network
Queen Elizabeth II Health Sciences Centre
St-Johns Health Sciences Centre
Centre hospitalier de l'Université de Montréal (CHUM)
Jewish General Hospital
Montreal General Hospital
Royal Victoria Hospital, Canada
Maisonneuve-Rosemont Hospital
St Mary's Hospital, London
Centre Hospitalier Pierre Boucher
Cité de la Santé Hospital
Centre Hospitalier Anna Laberge
Hotel Dieu Hospital
CHAUQ - Hopital Saint Sacrement and Hopital Enfant Jesus
CISSS de Chaudière-Appalaches
Hamilton Health Sciences Corporation
Unity Health Toronto
Sunnybrook Health Sciences Centre
Toronto General Hospital
York Central Hospital, Ontario
Lakeridge Health Corporation
Guelph General Hospital
London Health Sciences Centre
The Ottawa Hospital
Kingston Health Sciences Centre
Scarborough General Hospital
Matsqui-Sumas-Abbotsford General Hospital and Mission Memorial Hospital
Vancouver General Hospital
Peter Lougheed Centre
Foothills Medical Centre
Alberta Health services
Grey Nuns Hospital
University of Alberta
Royal Alexandra Hospital
Misericordia
Royal University Hospital Foundation
Regina General Hospital
University of Manitoba
McGill University Health Centre/Research Institute of the McGill University Health Centre
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age 18 or over. * Treated during the study duration * Primary or secondary discharge diagnoses of NVUGIB (per charted ICD-10 code). Additional confirmation of NVUGIB using endoscopic findings or patient symptoms done as previous.
Exclusion criteria
* Patients initially assessed at another institution for the present episode of NVUGIB and subsequently transferred to the participating site with unavailable initial data. * Endoscopy noted no gastro-duodenal ulcer bleeding, to ensure patient homogeneity.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Adherence to guidelines G10 and G17 of the 2003 International Consensus Guidelines on nonvariceal upper GI bleeding. | 1 year |
Secondary
| Measure | Time frame |
|---|---|
| Adherence to guidelines G10 or G17 alone, G5b, G6, G7a, G7b , G7c, G18 of the 2003 International Consensus Conference on nonvariceal upper GI bleeding. | 1 year |
Outcome results
None listed