Thrombolysis ImPlementation in Stroke (TIPS): Evaluating the effectiveness of a strategy to increase the adoption of best evidence practice - protocol for a cluster randomised controlled trial in acute stroke care

Paul, Christine L., Levi, Christopher R., D'Este, Catherine A., Parsons, Mark W., Bladin, Christopher F., Lindley, Richard I., Attia John R., Henskens, Frans, Lalor, Erin, Longworth, Mark, Middleton, Sandy, Ryan, Annika, Kerr, Erin, Sanson-Fisher, Robert W., The Thrombolysis ImPlementation in Stroke (TIPS) Study Group and Grimley, Rohan (2014) Thrombolysis ImPlementation in Stroke (TIPS): Evaluating the effectiveness of a strategy to increase the adoption of best evidence practice - protocol for a cluster randomised controlled trial in acute stroke care. Implementation Science, 9 38: . doi:10.1186/1748-5908-9-38

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Author Paul, Christine L.
Levi, Christopher R.
D'Este, Catherine A.
Parsons, Mark W.
Bladin, Christopher F.
Lindley, Richard I.
Attia John R.
Henskens, Frans
Lalor, Erin
Longworth, Mark
Middleton, Sandy
Ryan, Annika
Kerr, Erin
Sanson-Fisher, Robert W.
The Thrombolysis ImPlementation in Stroke (TIPS) Study Group
Grimley, Rohan
Total Author Count Override 975
Title Thrombolysis ImPlementation in Stroke (TIPS): Evaluating the effectiveness of a strategy to increase the adoption of best evidence practice - protocol for a cluster randomised controlled trial in acute stroke care
Journal name Implementation Science   Check publisher's open access policy
ISSN 1748-5908
Publication date 2014-03-25
Year available 2014
Sub-type Article (original research)
DOI 10.1186/1748-5908-9-38
Open Access Status DOI
Volume 9
Issue 38
Total pages 13
Place of publication London, United Kingdom
Publisher BioMed Central
Collection year 2015
Language eng
Abstract Background: Stroke is a leading cause of death and disability internationally. One of the three effective interventions in the acute phase of stroke care is thrombolytic therapy with tissue plasminogen activator (tPA), if given within 4.5 hours of onset to appropriate cases of ischaemic stroke.Objectives: To test the effectiveness of a multi-component multidisciplinary collaborative approach compared to usual care as a strategy for increasing thrombolysis rates for all stroke patients at intervention hospitals, while maintaining accepted benchmarks for low rates of intracranial haemorrhage and high rates of functional outcomes for both groups at three months.Methods and design: A cluster randomised controlled trial of 20 hospitals across 3 Australian states with 2 groups: multi- component multidisciplinary collaborative intervention as the experimental group and usual care as the control group. The intervention is based on behavioural theory and analysis of the steps, roles and barriers relating to rapid assessment for thrombolysis eligibility; it involves a comprehensive range of strategies addressing individual-level and system-level change at each site. The primary outcome is the difference in tPA rates between the two groups post-intervention. The secondary outcome is the proportion of tPA treated patients in both groups with good functional outcomes (modified Rankin Score (mRS <2) and the proportion with intracranial haemorrhage (mRS ≥2), compared to international benchmarks.Discussion: TIPS will trial a comprehensive, multi-component and multidisciplinary collaborative approach to improving thrombolysis rates at multiple sites. The trial has the potential to identify methods for optimal care which can be implemented for stroke patients during the acute phase. Study findings will include barriers and solutions to effective thrombolysis implementation and trial outcomes will be published whether significant or not.Trial registration: Australian New Zealand Clinical Trials Registry: ACTRN12613000939796.
Keyword Acute stroke
Cluster randomised controlled trial
Collaborative intervention
Evidence based practice
Multidisciplinary approach
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Medicine Publications
 
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