The evaluation of a tailored intervention to improve the management of suspected viral encephalitis: protocol for a cluster randomised controlled trial

Ruth Backman; Robbie Foy; Peter J Diggle; Rachel Kneen; Sylviane Defres; Benedict Daniel Michael; Antonieta Medina-Lara; Tom Solomon

doi:10.1186/s13012-014-0201-1

The evaluation of a tailored intervention to improve the management of suspected viral encephalitis: protocol for a cluster randomised controlled trial

Ruth Backman, Robbie Foy, Peter J Diggle, Rachel Kneen, Sylviane Defres, Benedict Daniel Michael, Antonieta Medina-Lara, Tom Solomon

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Abstract

BACKGROUND: Viral encephalitis is a devastating condition for which delayed treatment is associated with increased morbidity and mortality. Clinical audits indicate substantial scope for improved detection and treatment. Improvement strategies should ideally be tailored according to identified needs and barriers to change. The aim of the study is to evaluate the effectiveness and cost-effectiveness of a tailored intervention to improve the secondary care management of suspected encephalitis.

METHODS/DESIGN: The study is a two-arm cluster randomised controlled trial with allocation by postgraduate deanery. Participants were identified from 24 hospitals nested within 12 postgraduate deaneries in the United Kingdom (UK). We developed a multifaceted intervention package including core and flexible components with embedded behaviour change techniques selected on the basis of identified needs and barriers to change. The primary outcome will be a composite of the proportion of patients with suspected encephalitis receiving timely and appropriate diagnostic lumbar puncture within 12 h of hospital admission and aciclovir treatment within 6 h. We will gather outcome data pre-intervention and up to 12 months post-intervention from patient records. Statistical analysis at the cluster level will be blind to allocation. An economic evaluation will estimate intervention cost-effectiveness from the health service perspective.

TRIAL REGISTRATION: Controlled Trials: ISRCTN06886935.

Original language	English
Article number	14
Number of pages	9
Journal	Implementation Science
Volume	10
DOIs	https://doi.org/10.1186/s13012-014-0201-1
Publication status	Published - 27 Jan 2015

Keywords

Encephalitis
Cluster randomised controlled trial
Guideline implementation
Protocol

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BackmanR2015EvaluationFinal published version, 618 KBLicence: Creative Commons: Attribution (CC BY)

https://doi.org/10.1186/s13012-014-0201-1Licence: Creative Commons: Attribution (CC BY)

Cite this

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title = "The evaluation of a tailored intervention to improve the management of suspected viral encephalitis: protocol for a cluster randomised controlled trial",

abstract = "BACKGROUND: Viral encephalitis is a devastating condition for which delayed treatment is associated with increased morbidity and mortality. Clinical audits indicate substantial scope for improved detection and treatment. Improvement strategies should ideally be tailored according to identified needs and barriers to change. The aim of the study is to evaluate the effectiveness and cost-effectiveness of a tailored intervention to improve the secondary care management of suspected encephalitis.METHODS/DESIGN: The study is a two-arm cluster randomised controlled trial with allocation by postgraduate deanery. Participants were identified from 24 hospitals nested within 12 postgraduate deaneries in the United Kingdom (UK). We developed a multifaceted intervention package including core and flexible components with embedded behaviour change techniques selected on the basis of identified needs and barriers to change. The primary outcome will be a composite of the proportion of patients with suspected encephalitis receiving timely and appropriate diagnostic lumbar puncture within 12 h of hospital admission and aciclovir treatment within 6 h. We will gather outcome data pre-intervention and up to 12 months post-intervention from patient records. Statistical analysis at the cluster level will be blind to allocation. An economic evaluation will estimate intervention cost-effectiveness from the health service perspective.TRIAL REGISTRATION: Controlled Trials: ISRCTN06886935.",

keywords = "Encephalitis, Cluster randomised controlled trial, Guideline implementation, Protocol",

author = "Ruth Backman and Robbie Foy and Diggle, {Peter J} and Rachel Kneen and Sylviane Defres and Michael, {Benedict Daniel} and Antonieta Medina-Lara and Tom Solomon",

year = "2015",

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doi = "10.1186/s13012-014-0201-1",

language = "English",

volume = "10",

journal = "Implementation Science",

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T1 - The evaluation of a tailored intervention to improve the management of suspected viral encephalitis

T2 - protocol for a cluster randomised controlled trial

AU - Backman, Ruth

AU - Foy, Robbie

AU - Diggle, Peter J

AU - Kneen, Rachel

AU - Defres, Sylviane

AU - Michael, Benedict Daniel

AU - Medina-Lara, Antonieta

AU - Solomon, Tom

PY - 2015/1/27

Y1 - 2015/1/27

N2 - BACKGROUND: Viral encephalitis is a devastating condition for which delayed treatment is associated with increased morbidity and mortality. Clinical audits indicate substantial scope for improved detection and treatment. Improvement strategies should ideally be tailored according to identified needs and barriers to change. The aim of the study is to evaluate the effectiveness and cost-effectiveness of a tailored intervention to improve the secondary care management of suspected encephalitis.METHODS/DESIGN: The study is a two-arm cluster randomised controlled trial with allocation by postgraduate deanery. Participants were identified from 24 hospitals nested within 12 postgraduate deaneries in the United Kingdom (UK). We developed a multifaceted intervention package including core and flexible components with embedded behaviour change techniques selected on the basis of identified needs and barriers to change. The primary outcome will be a composite of the proportion of patients with suspected encephalitis receiving timely and appropriate diagnostic lumbar puncture within 12 h of hospital admission and aciclovir treatment within 6 h. We will gather outcome data pre-intervention and up to 12 months post-intervention from patient records. Statistical analysis at the cluster level will be blind to allocation. An economic evaluation will estimate intervention cost-effectiveness from the health service perspective.TRIAL REGISTRATION: Controlled Trials: ISRCTN06886935.

AB - BACKGROUND: Viral encephalitis is a devastating condition for which delayed treatment is associated with increased morbidity and mortality. Clinical audits indicate substantial scope for improved detection and treatment. Improvement strategies should ideally be tailored according to identified needs and barriers to change. The aim of the study is to evaluate the effectiveness and cost-effectiveness of a tailored intervention to improve the secondary care management of suspected encephalitis.METHODS/DESIGN: The study is a two-arm cluster randomised controlled trial with allocation by postgraduate deanery. Participants were identified from 24 hospitals nested within 12 postgraduate deaneries in the United Kingdom (UK). We developed a multifaceted intervention package including core and flexible components with embedded behaviour change techniques selected on the basis of identified needs and barriers to change. The primary outcome will be a composite of the proportion of patients with suspected encephalitis receiving timely and appropriate diagnostic lumbar puncture within 12 h of hospital admission and aciclovir treatment within 6 h. We will gather outcome data pre-intervention and up to 12 months post-intervention from patient records. Statistical analysis at the cluster level will be blind to allocation. An economic evaluation will estimate intervention cost-effectiveness from the health service perspective.TRIAL REGISTRATION: Controlled Trials: ISRCTN06886935.

KW - Encephalitis

KW - Cluster randomised controlled trial

KW - Guideline implementation

KW - Protocol

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DO - 10.1186/s13012-014-0201-1

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SN - 1748-5908

VL - 10

JO - Implementation Science

JF - Implementation Science

M1 - 14

ER -

The evaluation of a tailored intervention to improve the management of suspected viral encephalitis: protocol for a cluster randomised controlled trial

Abstract

Keywords

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