13 results on '"Craig, Louise E."'
Search Results
2. Early Mobilization After Stroke: An Example of an Individual Patient Data Meta-Analysis of a Complex Intervention
- Author
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Craig, Louise E., Bernhardt, Julie, Langhorne, Peter, and Wu, Olivia
- Published
- 2010
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3. Does the Addition of Non-Approved Inclusion and Exclusion Criteria for rtPA Impact Treatment Rates? Findings in Australia, the UK, and the USA
- Author
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Craig, Louise E., primary, Middleton, Sandy, additional, Hamilton, Helen, additional, Cudlip, Fern, additional, Swatzell, Victoria, additional, Alexandrov, Andrei V., additional, Lightbody, Elizabeth, additional, Watkins, Dame Caroline, additional, Philip, Sheeba, additional, Cadilhac, Dominique A., additional, McInnes, Elizabeth, additional, Dale, Simeon, additional, and Alexandrov, Anne W., additional
- Published
- 2018
- Full Text
- View/download PDF
4. Development of a theory-informed implementation intervention to improve the triage, treatment and transfer of stroke patients in emergency departments using the Theoretical Domains Framework (TDF): the T3 Trial
- Author
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Craig, Louise E., primary, Taylor, Natalie, additional, Grimley, Rohan, additional, Cadilhac, Dominique A., additional, McInnes, Elizabeth, additional, Phillips, Rosemary, additional, Dale, Simeon, additional, O’Connor, Denise, additional, Levi, Chris, additional, Fitzgerald, Mark, additional, Considine, Julie, additional, Grimshaw, Jeremy M., additional, Gerraty, Richard, additional, Cheung, N. Wah, additional, Ward, Jeanette, additional, and Middleton, Sandy, additional
- Published
- 2017
- Full Text
- View/download PDF
5. Testing a systematic approach to identify and prioritise barriers to successful implementation of a complex healthcare intervention
- Author
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Craig, Louise E., primary, Churilov, Leonid, additional, Olenko, Liudmyla, additional, Cadilhac, Dominique A., additional, Grimley, Rohan, additional, Dale, Simeon, additional, Martinez-Garduno, Cintia, additional, McInnes, Elizabeth, additional, Considine, Julie, additional, Grimshaw, Jeremy M., additional, and Middleton, Sandy, additional
- Published
- 2017
- Full Text
- View/download PDF
6. Identifying the barriers and enablers for a triage, treatment, and transfer clinical intervention to manage acute stroke patients in the emergency department: a systematic review using the theoretical domains framework (TDF)
- Author
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Craig, Louise E., primary, McInnes, Elizabeth, additional, Taylor, Natalie, additional, Grimley, Rohan, additional, Cadilhac, Dominique A., additional, Considine, Julie, additional, and Middleton, Sandy, additional
- Published
- 2016
- Full Text
- View/download PDF
7. Does the Addition of Non-Approved Inclusion and Exclusion Criteria for rtPA Impact Treatment Rates? Findings in Australia, the UK, and the USA
- Author
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Craig, Louise E., Middleton, Sandy, Hamilton, Helen, Cudlip, Fern, Swatzell, Victoria, Alexandrov, Andrei V., Lightbody, Elizabeth, Watkins, Dame Caroline, Philip, Sheeba, Cadilhac, Dominique A., McInnes, Elizabeth, Dale, Simeon, and Alexandrov, Anne W.
- Abstract
Background:Strict criteria for recombinant tissue plasminogen activator (rtPA) eligibility are stipulated on licences for use in ischaemic stroke; however, practitioners may also add non-standard rtPA criteria. We examined eligibility criteria variation in 3 English-speaking countries including use of non-standard criteria, in relation to rtPA treatment rates. Methods:Surveys were mailed to 566 eligible hospitals in Australia (AUS), the UK, and the USA. Criteria were pre-classified as standard (approved indication and contraindications) or non-standard (approved warning or researcher “decoy”). Percentage for criterion selection was calculated/compared; linear regression was used to assess the association between use of non-standard criteria and rtPA treatment rates, and to identify factors associated with addition of non-standard criteria. Results:Response rates were 74% AUS, 65% UK, and 68% USA; mean rtPA treatment rates were 8.7% AUS, 12.7% UK, and 8.7% USA. Median percentage of non-standard inclusions was 33% (all 3 countries) and included National Institutes of Health Stroke Scale (NIHSS) scores > 4, computed tomography (CT) angiography documented occlusion, and favourable CT perfusion. Median percentage of non-standard exclusions was 25% AUS, 28% UK, and 60% USA, and included depressed consciousness, NIHSS > 25, and use of antihypertensive infusions. No AUS or UK sites selected 100% of standard exclusions. Conclusions:Non-standard criteria for rtPA eligibility were evident in all three countries and could, in part, explain comparably low use of rtPA. Differences in the use of standard criteria may signify practitioner intolerance for those derived from original efficacy studies that are no longer relevant.
- Published
- 2020
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8. Implementing a complex rehabilitation intervention in a stroke trial: a qualitative process evaluation of AVERT
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Luker, Julie A, primary, Craig, Louise E, additional, Bennett, Leanne, additional, Ellery, Fiona, additional, Langhorne, Peter, additional, Wu, Olivia, additional, and Bernhardt, Julie, additional
- Published
- 2016
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9. Development of a theory-informed implementation intervention to improve the triage, treatment and transfer of stroke patients in emergency departments using the Theoretical Domains Framework (TDF): the T3 Trial.
- Author
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Craig, Louise E., Taylor, Natalie, Grimley, Rohan, Cadilhac, Dominique A., McInnes, Elizabeth, Phillips, Rosemary, Dale, Simeon, O'Connor, Denise, Levi, Chris, Fitzgerald, Mark, Considine, Julie, Grimshaw, Jeremy M., Gerraty, Richard, Cheung, N. Wah, Ward, Jeanette, and Middleton, Sandy
- Subjects
- *
STROKE treatment , *MEDICAL triage , *HOSPITAL emergency services , *TRANSITIONAL care , *BEHAVIOR modification , *CLINICAL trials , *STROKE diagnosis , *ATTITUDE (Psychology) , *BLOOD sugar , *BODY temperature , *CLINICAL medicine , *COMPARATIVE studies , *EMPLOYEE orientation , *HOSPITAL admission & discharge , *LONGITUDINAL method , *RESEARCH methodology , *MEDICAL cooperation , *MEDICAL personnel , *MEDICAL protocols , *PSYCHOLOGY , *QUALITY assurance , *RESEARCH , *THROMBOLYTIC therapy , *THEORY , *OCCUPATIONAL roles , *EVALUATION research , *KEY performance indicators (Management) , *RANDOMIZED controlled trials , *BLIND experiment , *HEALTH facility employees - Abstract
Background: Theoretical frameworks and models based on behaviour change theories are increasingly used in the development of implementation interventions. Development of an implementation intervention is often based on the available evidence base and practical issues, i.e. feasibility and acceptability. The aim of this study was to describe the development of an implementation intervention for the T3 Trial (Triage, Treatment and Transfer of patients with stroke in emergency departments (EDs)) using theory to recommend behaviour change techniques (BCTs) and drawing on the research evidence base and practical issues of feasibility and acceptability.Methods: A stepped method for developing complex interventions based on theory, evidence and practical issues was adapted using the following steps: (1) Who needs to do what, differently? (2) Using a theoretical framework, which barriers and enablers need to be addressed? (3) Which intervention components (behaviour change techniques and mode(s) of delivery) could overcome the modifiable barriers and enhance the enablers? A researcher panel was convened to review the list of BCTs recommended for use and to identify the most feasible and acceptable techniques to adopt.Results: Seventy-six barriers were reported by hospital staff who attended the workshops (step 1: thirteen TDF domains likely to influence the implementation of the T3 Trial clinical intervention were identified by the researchers; step 2: the researcher panellists then selected one third of the BCTs recommended for use as appropriate for the clinical context of the ED and, using the enabler workshop data, devised enabling strategies for each of the selected BCTs; and step 3: the final implementation intervention consisted of 27 BCTs).Conclusions: The TDF was successfully applied in all steps of developing an implementation intervention for the T3 Trial clinical intervention. The use of researcher panel opinion was an essential part of the BCT selection process to incorporate both research evidence and expert judgment. It is recommended that this stepped approach (theory, evidence and practical issues of feasibility and acceptability) is used to develop highly reportable implementation interventions. The classifying of BCTs using recognised implementation intervention components will facilitate generalisability and sharing across different conditions and clinical settings. [ABSTRACT FROM AUTHOR]- Published
- 2017
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10. Interventions for the uptake of evidence‐based recommendations in acute stroke settings
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Elizabeth A Lynch, Sandy Middleton, Louise E. Craig, Julie Bernhardt, Ian D. Graham, Tharshanah Thayabaranathan, Dominique A Cadilhac, Julie Luker, Luker, Julie A, Bernhardt, Julie, Graham, Ian D, Middleton, Sandy, Lynch, Elizabeth A, Thayabaranathan, Tharshanah, Craig, Louise E, and Cadilhac, Donique A
- Subjects
Medicine General & Introductory Medical Sciences ,medicine.medical_specialty ,Evidence-based practice ,business.industry ,Psychological intervention ,acute stroke unit ,evidence based recommendations ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,Pharmacology (medical) ,030212 general & internal medicine ,Medical emergency ,business ,Intensive care medicine ,030217 neurology & neurosurgery ,Acute stroke - Abstract
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the effects of implementation interventions for promoting the uptake of evidence-based recommendations in acute stroke unit environments. Secondary objectives are to describe any factors that may modify the effect of implementation interventions; determine factors that may influence the uptake of recommendations in acute stroke units; and determine if single or multifaceted intervention strategies (two or more interventions) are more effective in improving uptake of evidence, patient outcomes, system outcomes or professionals' knowledge, attitudes or intentions in this setting. Refereed/Peer-reviewed
- Published
- 2017
11. Implementing a complex rehabilitation intervention in a stroke trial: a qualitative process evaluation of AVERT
- Author
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Peter Langhorne, Fiona Ellery, Louise E. Craig, Julie Luker, Olivia Wu, Julie Bernhardt, Leanne Bennett, Luker, Julie A, Craig, Louise E, Bennett, Leanne, Ellery, Fiona, Langhorne, Peter, Wu, Olivia, and Bernhardt, Julie
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medicine.medical_specialty ,Attitude of Health Personnel ,Epidemiology ,medicine.medical_treatment ,media_common.quotation_subject ,Staffing ,Health Informatics ,clinical research protocol ,law.invention ,rehabilitation ,Interviews as Topic ,03 medical and health sciences ,Clinical trials ,Clinical research protocol ,0302 clinical medicine ,Nursing ,Randomized controlled trial ,law ,Qualitative research ,Health care ,Humans ,Medicine ,030212 general & internal medicine ,implementation ,media_common ,lcsh:R5-920 ,Teamwork ,clinical trials ,Rehabilitation ,business.industry ,Australia ,Stroke Rehabilitation ,stroke ,3. Good health ,Stroke ,Clinical trial ,Health Care Sciences & Services ,Scotland ,Implementation ,Physical therapy ,Thematic analysis ,lcsh:Medicine (General) ,business ,030217 neurology & neurosurgery ,qualitative research ,New Zealand ,Research Article - Abstract
Background The implementation of multidisciplinary stroke rehabilitation interventions is challenging, even when the intervention is evidence-based. Very little is known about the implementation of complex interventions in rehabilitation clinical trials. The aim of study was to better understand how the implementation of a rehabilitation intervention in a clinical trial within acute stroke units is experienced by the staff involved. This qualitative process evaluation was part of a large Phase III stroke rehabilitation trial (AVERT). Methods A descriptive qualitative approach was used. We purposively sampled 53 allied health and nursing staff from 19 acute stroke units in Australia, New Zealand and Scotland. Semi-structured interviews were conducted by phone, voice-internet, or face to face. Digitally recorded interviews were transcribed and analysed by two researchers using rigorous thematic analysis. Results Our analysis uncovered ten important themes that provide insight into the challenges of implementing complex new rehabilitation practices within complex care settings, plus factors and strategies that assisted implementation. Themes were grouped into three main categories: staff experience of implementing the trial intervention, barriers to implementation, and overcoming the barriers. Participation in the trial was challenging but had personal rewards and improved teamwork at some sites. Over the years that the trial ran some staff perceived a change in usual care. Barriers to trial implementation at some sites included poor teamwork, inadequate staffing, various organisational barriers, staff attitudes and beliefs, and patient-related barriers. Participants described successful implementation strategies that were built on interdisciplinary teamwork, education and strong leadership to ‘get staff on board’, and developing different ways of working. Conclusions The AVERT stroke rehabilitation trial required commitment to deliver an intervention that needed strong collaboration between nurses and physiotherapists and was different to current care models. This qualitative process evaluation contributes unique insights into factors that may be critical to successful trials teams, and as AVERT was a pragmatic trial, success factors to delivering complex intervention in clinical practice. Trial registration AVERT registered with Australian New Zealand Clinical Trials Registry ACTRN12606000185561. Electronic supplementary material The online version of this article (doi:10.1186/s12874-016-0156-9) contains supplementary material, which is available to authorized users.
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12. Non-pharmacological interventions for preventing delirium in hospitalised non-ICU patients.
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Burton JK, Craig LE, Yong SQ, Siddiqi N, Teale EA, Woodhouse R, Barugh AJ, Shepherd AM, Brunton A, Freeman SC, Sutton AJ, and Quinn TJ
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- Aged, Aged, 80 and over, Bias, Blood Transfusion, Combined Modality Therapy methods, Delirium epidemiology, Hospital Mortality, Humans, Incidence, Length of Stay, Network Meta-Analysis, Randomized Controlled Trials as Topic, Delirium prevention & control, Inpatients
- Abstract
Background: Delirium is an acute neuropsychological disorder that is common in hospitalised patients. It can be distressing to patients and carers and it is associated with serious adverse outcomes. Treatment options for established delirium are limited and so prevention of delirium is desirable. Non-pharmacological interventions are thought to be important in delirium prevention. OBJECTIVES: To assess the effectiveness of non-pharmacological interventions designed to prevent delirium in hospitalised patients outside intensive care units (ICU)., Search Methods: We searched ALOIS, the specialised register of the Cochrane Dementia and Cognitive Improvement Group, with additional searches conducted in MEDLINE, Embase, PsycINFO, CINAHL, LILACS, Web of Science Core Collection, ClinicalTrials.gov and the World Health Organization Portal/ICTRP to 16 September 2020. There were no language or date restrictions applied to the electronic searches, and no methodological filters were used to restrict the search., Selection Criteria: We included randomised controlled trials (RCTs) of single and multicomponent non-pharmacological interventions for preventing delirium in hospitalised adults cared for outside intensive care or high dependency settings. We only included non-pharmacological interventions which were designed and implemented to prevent delirium. DATA COLLECTION AND ANALYSIS: Two review authors independently examined titles and abstracts identified by the search for eligibility and extracted data from full-text articles. Any disagreements on eligibility and inclusion were resolved by consensus. We used standard Cochrane methodological procedures. The primary outcomes were: incidence of delirium; inpatient and later mortality; and new diagnosis of dementia. We included secondary and adverse outcomes as pre-specified in the review protocol. We used risk ratios (RRs) as measures of treatment effect for dichotomous outcomes and between-group mean differences for continuous outcomes. The certainty of the evidence was assessed using GRADE. A complementary exploratory analysis was undertaker using a Bayesian component network meta-analysis fixed-effect model to evaluate the comparative effectiveness of the individual components of multicomponent interventions and describe which components were most strongly associated with reducing the incidence of delirium., Main Results: We included 22 RCTs that recruited a total of 5718 adult participants. Fourteen trials compared a multicomponent delirium prevention intervention with usual care. Two trials compared liberal and restrictive blood transfusion thresholds. The remaining six trials each investigated a different non-pharmacological intervention. Incidence of delirium was reported in all studies. Using the Cochrane risk of bias tool, we identified risks of bias in all included trials. All were at high risk of performance bias as participants and personnel were not blinded to the interventions. Nine trials were at high risk of detection bias due to lack of blinding of outcome assessors and three more were at unclear risk in this domain. Pooled data showed that multi-component non-pharmacological interventions probably reduce the incidence of delirium compared to usual care (10.5% incidence in the intervention group, compared to 18.4% in the control group, risk ratio (RR) 0.57, 95% confidence interval (CI) 0.46 to 0.71, I
2 = 39%; 14 studies; 3693 participants; moderate-certainty evidence, downgraded due to risk of bias). There may be little or no effect of multicomponent interventions on inpatient mortality compared to usual care (5.2% in the intervention group, compared to 4.5% in the control group, RR 1.17, 95% CI 0.79 to 1.74, I2 = 15%; 10 studies; 2640 participants; low-certainty evidence downgraded due to inconsistency and imprecision). No studies of multicomponent interventions reported data on new diagnoses of dementia. Multicomponent interventions may result in a small reduction of around a day in the duration of a delirium episode (mean difference (MD) -0.93, 95% CI -2.01 to 0.14 days, I2 = 65%; 351 participants; low-certainty evidence downgraded due to risk of bias and imprecision). The evidence is very uncertain about the effect of multicomponent interventions on delirium severity (standardised mean difference (SMD) -0.49, 95% CI -1.13 to 0.14, I2 =64%; 147 participants; very low-certainty evidence downgraded due to risk of bias and serious imprecision). Multicomponent interventions may result in a reduction in hospital length of stay compared to usual care (MD -1.30 days, 95% CI -2.56 to -0.04 days, I2 =91%; 3351 participants; low-certainty evidence downgraded due to risk of bias and inconsistency), but little to no difference in new care home admission at the time of hospital discharge (RR 0.77, 95% CI 0.55 to 1.07; 536 participants; low-certainty evidence downgraded due to risk of bias and imprecision). Reporting of other adverse outcomes was limited. Our exploratory component network meta-analysis found that re-orientation (including use of familiar objects), cognitive stimulation and sleep hygiene were associated with reduced risk of incident delirium. Attention to nutrition and hydration, oxygenation, medication review, assessment of mood and bowel and bladder care were probably associated with a reduction in incident delirium but estimates included the possibility of no benefit or harm. Reducing sensory deprivation, identification of infection, mobilisation and pain control all had summary estimates that suggested potential increases in delirium incidence, but the uncertainty in the estimates was substantial. Evidence from two trials suggests that use of a liberal transfusion threshold over a restrictive transfusion threshold probably results in little to no difference in incident delirium (RR 0.92, 95% CI 0.62 to 1.36; I2 = 9%; 294 participants; moderate-certainty evidence downgraded due to risk of bias). Six other interventions were examined, but evidence for each was limited to single studies and we identified no evidence of delirium prevention. AUTHORS' CONCLUSIONS: There is moderate-certainty evidence regarding the benefit of multicomponent non-pharmacological interventions for the prevention of delirium in hospitalised adults, estimated to reduce incidence by 43% compared to usual care. We found no evidence of an effect on mortality. There is emerging evidence that these interventions may reduce hospital length of stay, with a trend towards reduced delirium duration, although the effect on delirium severity remains uncertain. Further research should focus on implementation and detailed analysis of the components of the interventions to support more effective, tailored practice recommendations., (Copyright © 2021 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.)- Published
- 2021
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13. Development of a theory-informed implementation intervention to improve the triage, treatment and transfer of stroke patients in emergency departments using the Theoretical Domains Framework (TDF): the T 3 Trial.
- Author
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Craig LE, Taylor N, Grimley R, Cadilhac DA, McInnes E, Phillips R, Dale S, O'Connor D, Levi C, Fitzgerald M, Considine J, Grimshaw JM, Gerraty R, Cheung NW, Ward J, and Middleton S
- Subjects
- Attitude of Health Personnel, Blood Glucose, Body Temperature, Emergency Service, Hospital standards, Guideline Adherence, Humans, Inservice Training, Patient Transfer standards, Practice Guidelines as Topic, Professional Role, Prospective Studies, Psychological Theory, Quality Indicators, Health Care, Single-Blind Method, Stroke diagnosis, Thrombolytic Therapy, Triage standards, Emergency Service, Hospital organization & administration, Patient Transfer organization & administration, Personnel, Hospital psychology, Quality Improvement organization & administration, Stroke therapy, Triage organization & administration
- Abstract
Background: Theoretical frameworks and models based on behaviour change theories are increasingly used in the development of implementation interventions. Development of an implementation intervention is often based on the available evidence base and practical issues, i.e. feasibility and acceptability. The aim of this study was to describe the development of an implementation intervention for the T
3 Trial (Triage, Treatment and Transfer of patients with stroke in emergency departments (EDs)) using theory to recommend behaviour change techniques (BCTs) and drawing on the research evidence base and practical issues of feasibility and acceptability., Methods: A stepped method for developing complex interventions based on theory, evidence and practical issues was adapted using the following steps: (1) Who needs to do what, differently? (2) Using a theoretical framework, which barriers and enablers need to be addressed? (3) Which intervention components (behaviour change techniques and mode(s) of delivery) could overcome the modifiable barriers and enhance the enablers? A researcher panel was convened to review the list of BCTs recommended for use and to identify the most feasible and acceptable techniques to adopt., Results: Seventy-six barriers were reported by hospital staff who attended the workshops (step 1: thirteen TDF domains likely to influence the implementation of the T3 Trial clinical intervention were identified by the researchers; step 2: the researcher panellists then selected one third of the BCTs recommended for use as appropriate for the clinical context of the ED and, using the enabler workshop data, devised enabling strategies for each of the selected BCTs; and step 3: the final implementation intervention consisted of 27 BCTs)., Conclusions: The TDF was successfully applied in all steps of developing an implementation intervention for the T3 Trial clinical intervention. The use of researcher panel opinion was an essential part of the BCT selection process to incorporate both research evidence and expert judgment. It is recommended that this stepped approach (theory, evidence and practical issues of feasibility and acceptability) is used to develop highly reportable implementation interventions. The classifying of BCTs using recognised implementation intervention components will facilitate generalisability and sharing across different conditions and clinical settings.- Published
- 2017
- Full Text
- View/download PDF
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