Abstract
BackgroundStrokes are a common cause of adult disability and mortality worldwide. Transient ischaemic attacks (TIA) are associated with a high risk of subsequent stroke, and rapid intervention has the potential to reduce stroke burden. This study will assess a novel electronic decision support (EDS) tool to allow general practitioners (GPs) to implement evidence-based care rapidly without full reliance on specialists.Methods/designThis is a cluster randomized controlled trial comparing TIA/stroke management of GPs with access to the EDS tool versus usual care. The intervention period is 12 months with a 3-month follow-up period for individual patients. Primary outcomes consist of stroke within 90 days of presenting event and adherence to the New Zealand national TIA guideline.DiscussionA positive study will provide strong evidence for widespread implementation of this tool in practice and has the potential to improve key outcomes for patients and reduce the burden of stroke.Trial registrationAustralia New Zealand Clinical Trials Registry ACTRN12611000792921
Highlights
Strokes are a common cause of adult disability and mortality worldwide
Throughout New Zealand, similar Best Practice Advocacy Centre Inc. (BPAC) decision support modules are used by 76% of general practices and 85% of general practitioner (GP)
GPs access this tool by clicking a menu button situated on the navigation bar of their practice management software that links them to the BPAC module site
Summary
The study was powered to achieve this outcome, but the only available data on post-TIA stroke rates is several years old, and the recent more widespread use of secondary preventive medications due to significant efforts toward cardiovascular risk reduction may have had a significant impact on current stroke rates. To account for this potential difficulty, we have selected a second primary outcome in the form of overall guideline adherence.
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