Brazilian Intervention to Increase Evidence Usage in Practice - Acute Coronary Syndromes

Study Overview
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Brief Summary
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Phase 1: An observational study (registry) will be conducted which will objectively document the ACS clinical practice in Brazilian public hospitals, and identify the important barriers for the evidence usage incorporation in the clinical practice. Phase 2: A Cluster randomized clinical trial in which public hospital will be randomized to receive or not a multifaceted strategy in order to increase evidence based therapy in clinical practice.

Detailed Description
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STUDY POPULATION: Patients with thoracic pain who the emergency department physician suspects of ACS and plans start a treatment for this issue; It will be excluded patients transferred of others institutions with 12 hours of symptoms. PROGRAM: There are multifaceted Interventions Including Distribution of educational materials Case manager: Use of a trained person who works in the hospital and will be responsible to assure that all interventions were used Reminders: specific information that is designed or intended to prompt a health professional to recall information (patient bracelets, labels, posters, pocket cards, checklists). Practical training ENDPOINTS: Phase 1 Primary outcome; patient who've received interventions based on evidence proportion informed by the indicators; Phase 2 Primary outcome: Increase of prescription of evidence based treatment in clinical practice Secondary outcome Total mortality and major cardiovascular events

Official Title
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Brazilian Intervention to Increase Evidence Usage in Practice - Acute Coronary Syndromes

Conditions
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Acute Coronary Syndrome

Intervention / Treatment
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* Other: multifaceted strategy


Participation Criteria
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Eligibility Criteria
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Patient Eligibility criteria Inclusion Criteria: Patients with thoracic pain who the emergency department physician suspects of ACS and plans start a treatment for this issue Exclusion Criteria: Patients transferred from others institutions within 12 hours of the symptoms Cluster Eligibility Criteria National Public Hospitals with emergency department. A cluster can be one hospital with emergency department, or 2 or more hospitals (for example: 1 emergency hospital and 1 general hospital which receive the patients to perform PCI).

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Quality improvement program<br>There are multifaceted Interventions for the clinic hospital team Including Distribution of educational materials Case manager Reminders Practical training | Other: multifaceted strategy<br>* There are multifaceted Interventions Including Distribution of educational materials: distribution of published or printed recommendations for clinical care. Case manager: Use of a trained person who works in the hospital and will be responsible to assure that all interventions were used Reminders Practical training<br>|
| No Intervention: Hospital standard treatment<br>Hospital standard treatment | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Phase 1: patient who've received interventions based on evidence proportion informed by the indicators |  | 9 months | 
| Phase 2: increase of prescription of evidence based treatment in clinical practice |  | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Total mortality and major cardiovascular events |  | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Acute Coronary Syndrome, randomized cluster trial, quality improvement