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Successful knowledge translation intervention in long-term care: final results from the vitamin D and osteoporosis study (ViDOS) pilot cluster randomized controlled trial

Overview of attention for article published in Trials, May 2015
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Title
Successful knowledge translation intervention in long-term care: final results from the vitamin D and osteoporosis study (ViDOS) pilot cluster randomized controlled trial
Published in
Trials, May 2015
DOI 10.1186/s13063-015-0720-3
Pubmed ID
Authors

Courtney C Kennedy, George Ioannidis, Lehana Thabane, Jonathan D Adachi, Sharon Marr, Lora M Giangregorio, Suzanne N Morin, Richard G Crilly, Robert G Josse, Lynne Lohfeld, Laura E Pickard, Mary-Lou van der Horst, Glenda Campbell, Jackie Stroud, Lisa Dolovich, Anna M Sawka, Ravi Jain, Lynn Nash, Alexandra Papaioannou

Abstract

Few studies have systematically examined whether knowledge translation (KT) strategies can be successfully implemented within the long-term care (LTC) setting. In this study, we examined the effectiveness of a multifaceted, interdisciplinary KT intervention for improving the prescribing of vitamin D, calcium and osteoporosis medications over 12-months. We conducted a pilot, cluster randomized controlled trial in 40 LTC homes (21 control; 19 intervention) in Ontario, Canada. LTC homes were eligible if they had more than one prescribing physician and received services from a large pharmacy provider. Participants were interdisciplinary care teams (physicians, nurses, consultant pharmacists, and other staff) who met quarterly. Intervention homes participated in three educational meetings over 12 months, including a standardized presentation led by expert opinion leaders, action planning for quality improvement, and audit and feedback review. Control homes did not receive any additional intervention. Resident-level prescribing and clinical outcomes were collected from the pharmacy database; data collectors and analysts were blinded. In addition to feasibility measures, study outcomes were the proportion of residents taking vitamin D (≥800 IU/daily; primary), calcium ≥500 mg/day and osteoporosis medications (high-risk residents) over 12 months. Data were analyzed using the generalized estimating equations technique accounting for clustering within the LTC homes. At baseline, 5,478 residents, mean age 84.4 (standard deviation (SD) 10.9), 71% female, resided in 40 LTC homes, mean size = 137 beds (SD 76.7). In the intention-to-treat analysis (21 control; 19 intervention clusters), the intervention resulted in a significantly greater increase in prescribing from baseline to 12 months between intervention versus control arms for vitamin D (odds ratio (OR) 1.82, 95% confidence interval (CI): 1.12, 2.96) and calcium (OR 1.33, 95% CI: 1.01, 1.74), but not for osteoporosis medications (OR 1.17, 95% CI: 0.91, 1.51). In secondary analyses, excluding seven nonparticipating intervention homes, ORs were 3.06 (95% CI: 2.18, 4.29), 1.57 (95% CI: 1.12, 2.21), 1.20 (95% CI: 0.90, 1.60) for vitamin D, calcium and osteoporosis medications, respectively. Our KT intervention significantly improved the prescribing of vitamin D and calcium and is a model that could potentially be applied to other areas requiring quality improvement. ClinicalTrials.gov: NCT01398527 . Registered: 19 July 2011.

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Geographical breakdown

Country Count As %
United Kingdom 1 <1%
Spain 1 <1%
Canada 1 <1%
Unknown 251 99%

Demographic breakdown

Readers by professional status Count As %
Student > Master 40 16%
Student > Bachelor 30 12%
Researcher 24 9%
Student > Ph. D. Student 20 8%
Other 15 6%
Other 51 20%
Unknown 74 29%
Readers by discipline Count As %
Medicine and Dentistry 56 22%
Nursing and Health Professions 44 17%
Psychology 11 4%
Social Sciences 9 4%
Agricultural and Biological Sciences 9 4%
Other 41 16%
Unknown 84 33%