Intervention RCT
It has been found that many patients with suspected encephalitis are not started on aciclovir treatment within 6 hours, or have an LP performed within the first 12 hours of admission; both of these are key features of the National encephalitis guidelines published in 2012. This study will evaluate both the clinical effectiveness and cost-effectiveness of an intervention to support the implementation of these encephalitis guidelines.
The use of a cluster randomised controlled trial (RCT) in up to twenty eight hospitals with an evaluation period of 12 months will allow both cost effectiveness and clinical outcomes to be assessed. The intervention will target clinicians responsible for the diagnosis and initial management of suspected encephalitis. Intervention development will be informed by existing evidence on professional behaviour change and sub-studies within the ENCEPH UK programme. This consists of semi structured interviews with health care professionals who have a variety of roles within several hospitals. From this, the major barriers and enablers to using the encephalitis guidelines will be deduced and a novel intervention package will be developed and implemented in randomised hospitals over twelve months, ideally with short training sessions every four months so that staff on new rotations are aware of the intervention over the course of one year.
Primary Outcome
The proportion of patients meeting the definition of suspected encephalitis whose care met both of the following criteria:
- Aciclovir given within 6 hours from admission to hospital; and
- A lumbar puncture performed within 12 hours of hospital arrival unless clinically contraindicated.
This study is now in the final data collection period and the current associated publications are listed below:
Study protocol: http://www.implementationscience.com/content/10/1/14
ISRCTN: http://www.isrctn.com/ISRCTN06886935
If you would like any information about this study, please contact Ruth Backman in the first instance: r.backman@liverpool.ac.uk