Please note that the copy function is not enabled for this field.
If you wish to
modify
existing outcomes, please copy and paste the current outcome text into the Update field.
LOGIN
CREATE ACCOUNT
MY TRIALS
LOGIN
CREATE ACCOUNT
MY TRIALS
REGISTER TRIAL
FAQs
HINTS AND TIPS
DEFINITIONS
Register a trial
The ANZCTR website will be unavailable from 1pm until 3pm (AEDT) on Wednesday the 30th of October for website maintenance. Please be sure to log out of the system in order to avoid any loss of data.
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been endorsed by the ANZCTR. Before participating in a study, talk to your health care provider and refer to this
information for consumers
Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT02835040
Registration number
NCT02835040
Ethics application status
Date submitted
22/05/2016
Date registered
15/07/2016
Titles & IDs
Public title
IMPROVinG Outcomes in Community Acquired Pneumonia
Query!
Scientific title
Evaluating the Impact of a New Model of Care Designed to Improve Evidence-based Management of Community-acquired Pneumonia
Query!
Secondary ID [1]
0
0
MH 2016.014
Query!
Universal Trial Number (UTN)
Query!
Trial acronym
IMPROVe-GAP
Query!
Linked study record
Query!
Health condition
Health condition(s) or problem(s) studied:
Pneumonia
0
0
Query!
Condition category
Condition code
Respiratory
0
0
0
0
Query!
Other respiratory disorders / diseases
Query!
Infection
0
0
0
0
Query!
Other infectious diseases
Query!
Infection
0
0
0
0
Query!
Studies of infection and infectious agents
Query!
Intervention/exposure
Study type
Interventional
Query!
Description of intervention(s) / exposure
Other interventions - New model of service delivery
Other interventions - Current practice
Experimental: CAP Service -
Active comparator: Usual care -
Other interventions: New model of service delivery
Introduction of a new CAP disease specific clinical team to ensure systematic implementation of standardized treatment protocols (similar to a clinical pathway) for interventions supported by Level-1 evidence.
Other interventions: Current practice
Interventions as determined by the treating General Medical team consistent with current usual practice.
Query!
Intervention code [1]
0
0
Other interventions
Query!
Comparator / control treatment
Query!
Control group
Query!
Outcomes
Primary outcome [1]
0
0
Hospital length of stay
Query!
Assessment method [1]
0
0
Query!
Timepoint [1]
0
0
Through study completion, an average of five days
Query!
Secondary outcome [1]
0
0
Hospital readmissions
Query!
Assessment method [1]
0
0
Query!
Timepoint [1]
0
0
Within 30-days and 90-days of discharge
Query!
Secondary outcome [2]
0
0
Individual per-separation admission costing
Query!
Assessment method [2]
0
0
Total cost per admission that can be directly attributed to patient inpatient stay as recorded by the Power Performance Manager software platform.
Query!
Timepoint [2]
0
0
From admission to emergency department until 90-days post-discharge
Query!
Secondary outcome [3]
0
0
In-hospital mortality
Query!
Assessment method [3]
0
0
Query!
Timepoint [3]
0
0
15 months
Query!
Secondary outcome [4]
0
0
Proportion of patients receiving each individual evidence-based treatment recommendation
Query!
Assessment method [4]
0
0
Query!
Timepoint [4]
0
0
15 months
Query!
Secondary outcome [5]
0
0
Proportion of patients receiving all evidence-based treatment recommendations
Query!
Assessment method [5]
0
0
Query!
Timepoint [5]
0
0
15-months
Query!
Secondary outcome [6]
0
0
Incidence of hyperglycaemia in known diabetics requiring new insulin prescription
Query!
Assessment method [6]
0
0
Query!
Timepoint [6]
0
0
15-months
Query!
Secondary outcome [7]
0
0
Falls or clinical deterioration during physiotherapy
Query!
Assessment method [7]
0
0
Query!
Timepoint [7]
0
0
15-months
Query!
Secondary outcome [8]
0
0
Admission to Intensive Care Unit from medical ward during admission
Query!
Assessment method [8]
0
0
Does not include admissions to ICU directly from the Emergency Department
Query!
Timepoint [8]
0
0
15-months
Query!
Secondary outcome [9]
0
0
Duration of mechanical ventilation and number of failed extubations
Query!
Assessment method [9]
0
0
Query!
Timepoint [9]
0
0
15-months
Query!
Secondary outcome [10]
0
0
Death within 30-days of presentation to hospital
Query!
Assessment method [10]
0
0
Query!
Timepoint [10]
0
0
30-days from date of presentation to the Emergency Department
Query!
Secondary outcome [11]
0
0
Death within 90-days of presentation to hospital
Query!
Assessment method [11]
0
0
Query!
Timepoint [11]
0
0
90-days from date of presentation to the Emergency Department
Query!
Eligibility
Key inclusion criteria
* Patients presenting to Footscray or Sunshine Hospital meeting the standardized definition for community acquired pneumonia.
Query!
Minimum age
18
Years
Query!
Query!
Maximum age
No limit
Query!
Query!
Sex
Both males and females
Query!
Can healthy volunteers participate?
No
Query!
Key exclusion criteria
* Palliated on admission.
* Enrolled in another inpatient clinical trial.
Withdrawal Criteria:
* Transferred to a non-General Medical Unit within 48-hours of admission.
* Transferred to another health service within 48-hours of admission.
Query!
Study design
Purpose of the study
Other
Query!
Allocation to intervention
Randomised controlled trial
Query!
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Query!
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Query!
Masking / blinding
Blinded (masking used)
Query!
Who is / are masked / blinded?
The people receiving the treatment/s
The people assessing the outcomes
Query!
Query!
Query!
Query!
Intervention assignment
Parallel
Query!
Other design features
Query!
Phase
NA
Query!
Type of endpoint/s
Query!
Statistical methods / analysis
Query!
Recruitment
Recruitment status
Completed
Query!
Data analysis
Query!
Reason for early stopping/withdrawal
Query!
Other reasons
Query!
Date of first participant enrolment
Anticipated
Query!
Actual
1/08/2016
Query!
Date of last participant enrolment
Anticipated
Query!
Actual
Query!
Date of last data collection
Anticipated
Query!
Actual
1/10/2017
Query!
Sample size
Target
Query!
Accrual to date
Query!
Final
814
Query!
Recruitment in Australia
Recruitment state(s)
VIC
Query!
Recruitment hospital [1]
0
0
Footscray Hospital - Footscray
Query!
Recruitment hospital [2]
0
0
Sunshine Hospital - St Albans
Query!
Recruitment postcode(s) [1]
0
0
3011 - Footscray
Query!
Recruitment postcode(s) [2]
0
0
3442 - St Albans
Query!
Funding & Sponsors
Primary sponsor type
Government body
Query!
Name
Western Health, Australia
Query!
Address
Query!
Country
Query!
Other collaborator category [1]
0
0
Other
Query!
Name [1]
0
0
University of Melbourne
Query!
Address [1]
0
0
Query!
Country [1]
0
0
Query!
Other collaborator category [2]
0
0
Other
Query!
Name [2]
0
0
Monash University
Query!
Address [2]
0
0
Query!
Country [2]
0
0
Query!
Other collaborator category [3]
0
0
Other
Query!
Name [3]
0
0
La Trobe University
Query!
Address [3]
0
0
Query!
Country [3]
0
0
Query!
Ethics approval
Ethics application status
Query!
Summary
Brief summary
Pneumonia is the commonest illness requiring hospitalization in Australia. Elderly patients account for most admissions and incur highest costs due to longer hospitalizations, higher readmission risks and poor functional outcomes. Previous clinical trials show a number of medical and allied health interventions can effectively shorten hospitalization or reduce readmissions, but these have been poorly and inconsistently applied in practice. This proposed research builds on previous studies by applying these interventions as a standardized combined package, evaluating their effectiveness in a "real world" Australian setting and quantifying effects on both clinical outcomes and health service costs.
Query!
Trial website
https://clinicaltrials.gov/study/NCT02835040
Query!
Trial related presentations / publications
Blum CA, Nigro N, Briel M, Schuetz P, Ullmer E, Suter-Widmer I, Winzeler B, Bingisser R, Elsaesser H, Drozdov D, Arici B, Urwyler SA, Refardt J, Tarr P, Wirz S, Thomann R, Baumgartner C, Duplain H, Burki D, Zimmerli W, Rodondi N, Mueller B, Christ-Crain M. Adjunct prednisone therapy for patients with community-acquired pneumonia: a multicentre, double-blind, randomised, placebo-controlled trial. Lancet. 2015 Apr 18;385(9977):1511-8. doi: 10.1016/S0140-6736(14)62447-8. Epub 2015 Jan 19. Mundy LM, Leet TL, Darst K, Schnitzler MA, Dunagan WC. Early mobilization of patients hospitalized with community-acquired pneumonia. Chest. 2003 Sep;124(3):883-9. doi: 10.1378/chest.124.3.883. Carratala J, Garcia-Vidal C, Ortega L, Fernandez-Sabe N, Clemente M, Albero G, Lopez M, Castellsague X, Dorca J, Verdaguer R, Martinez-Montauti J, Manresa F, Gudiol F. Effect of a 3-step critical pathway to reduce duration of intravenous antibiotic therapy and length of stay in community-acquired pneumonia: a randomized controlled trial. Arch Intern Med. 2012 Jun 25;172(12):922-8. doi: 10.1001/archinternmed.2012.1690. Siemieniuk RA, Meade MO, Alonso-Coello P, Briel M, Evaniew N, Prasad M, Alexander PE, Fei Y, Vandvik PO, Loeb M, Guyatt GH. Corticosteroid Therapy for Patients Hospitalized With Community-Acquired Pneumonia: A Systematic Review and Meta-analysis. Ann Intern Med. 2015 Oct 6;163(7):519-28. doi: 10.7326/M15-0715. Marti C, Grosgurin O, Harbarth S, Combescure C, Abbas M, Rutschmann O, Perrier A, Garin N. Adjunctive Corticotherapy for Community Acquired Pneumonia: A Systematic Review and Meta-Analysis. PLoS One. 2015 Dec 7;10(12):e0144032. doi: 10.1371/journal.pone.0144032. eCollection 2015. Torres A, Sibila O, Ferrer M, Polverino E, Menendez R, Mensa J, Gabarrus A, Sellares J, Restrepo MI, Anzueto A, Niederman MS, Agusti C. Effect of corticosteroids on treatment failure among hospitalized patients with severe community-acquired pneumonia and high inflammatory response: a randomized clinical trial. JAMA. 2015 Feb 17;313(7):677-86. doi: 10.1001/jama.2015.88. Lloyd MA, Tang CY, Callander EJ, Janus ED, Karahalios A, Skinner EH, Lowe S, Karunajeewa HA. Patient-reported outcome measurement in community-acquired pneumonia: feasibility of routine application in an elderly hospitalized population. Pilot Feasibility Stud. 2019 Jul 27;5:97. doi: 10.1186/s40814-019-0481-y. eCollection 2019. Lloyd M, Karahalios A, Janus E, Skinner EH, Haines T, De Silva A, Lowe S, Shackell M, Ko S, Desmond L, Karunajeewa H; Improving Evidence-Based Treatment Gaps and Outcomes in Community-Acquired Pneumonia (IMPROVE-GAP) Implementation Team at Western Health. Effectiveness of a Bundled Intervention Including Adjunctive Corticosteroids on Outcomes of Hospitalized Patients With Community-Acquired Pneumonia: A Stepped-Wedge Randomized Clinical Trial. JAMA Intern Med. 2019 Aug 1;179(8):1052-1060. doi: 10.1001/jamainternmed.2019.1438. Skinner EH, Lloyd M, Janus E, Ong ML, Karahalios A, Haines TP, Kelly AM, Shackell M, Karunajeewa H. The IMPROVE-GAP Trial aiming to improve evidence-based management of community-acquired pneumonia: study protocol for a stepped-wedge randomised controlled trial. Trials. 2018 Feb 5;19(1):88. doi: 10.1186/s13063-017-2407-4.
Query!
Public notes
Query!
Contacts
Principal investigator
Name
0
0
Query!
Address
0
0
Query!
Country
0
0
Query!
Phone
0
0
Query!
Fax
0
0
Query!
Email
0
0
Query!
Contact person for public queries
Name
0
0
Query!
Address
0
0
Query!
Country
0
0
Query!
Phone
0
0
Query!
Fax
0
0
Query!
Email
0
0
Query!
Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
Query!
No/undecided IPD sharing reason/comment
Query!
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT02835040