The Dissemination of Consensus Recommendations on Upper Gastrointestinal Bleeding

Study Overview
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Brief Summary
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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
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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.

Official Title
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The Dissemination of Consensus Recommendations on the Management of Canadian Patients With Non Variceal Upper Gastrointestinal Bleeding: A National Cluster Randomized Trial of a Multifaceted Tailored Implementation Strategy

Conditions
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Peptic Ulcer Hemorrhage

Intervention / Treatment
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* Other: Educational intervention


Participation Criteria
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Eligibility Criteria
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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.

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: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Educational intervention<br>see protocol | Other: Educational intervention<br>* As per detailed protocol.<br>* Other names: Multifacetted tailored educational intervention;|
| No Intervention: Standard care<br>distribution of guidelines and a published algorithm | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Adherence to guidelines G10 and G17 of the 2003 International Consensus Guidelines on nonvariceal upper GI bleeding. |  | 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | 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 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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peptic ulcer bleeding, upper GI hemorrhage, adherence to guidelines, knowledge transfer