Cluster randomised trial of an active, multifaceted educational intervention based on the WHO Reproductive Health Library to improve obstetric practices

ObjectiveThe aim was to test if targeting managers with an educational intervention reduces absence among pregnant employees.MethodsThe study was a non-blinded cluster randomised trial conducted in hospitals and daycare institutions from two administrative Danish Regions and two Danish municipalities. Clusters (work units) were assigned randomly and non-blinded to either (1) intervention, where all managers were invited to participate in a 3-hour seminar addressing needs and options for adjustment of work in pregnancy, or (2) control, with practice as usual. The primary outcome based on payroll data was long-term pregnancy-related absence, defined as ≥12.5% cumulated absence during pregnancy weeks 1–32. Intention-to-treat analysis was applied using mixed logistic regression.ResultsNinety work units were included (56 hospital departments and 34 daycare units) with 451 pregnant employees in the intervention group and 464 in the control group. Work units had on average 11 pregnant employees with no difference between the groups. 103 of the 216 invited managers (48%) participated in a the 3-hour seminar. In the intervention group, 154 (34%) had long-term pregnancy-related absence during pregnancy weeks 1–32 vs 166 (36%) in the control group. Relative odds of having long-term pregnancy-related absence, when being in the intervention group, was 1.06 (95% CI 0.71 to 1.58), with an interclass correlation coefficient of 0.07.ConclusionAn educational intervention targeting managers did not reduce pregnancy-related absence among pregnant employees.Trial registration numberNCT03002987.

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Protocol of a tailored educational intervention for general practitioners on potentially inappropriate medications among older patients at community healthcare institutions in Beijing, China: a cluster-randomised controlled trial

BMJ Open ◽

10.1136/bmjopen-2020-046942 ◽

2021 ◽

Vol 11 (7) ◽

pp. e046942

Author(s):

Mengyuan Fu ◽

Haishaerjiang Wushouer ◽

Xiaoyan Nie ◽

Nan Li ◽

Xinyan Zhang ◽

...

Keyword(s):

Elderly Patients ◽

General Practitioners ◽

Educational Intervention ◽

Randomised Trial ◽

Cluster Randomised Trial ◽

Routine Practice ◽

Potentially Inappropriate Medications ◽

Community Healthcare ◽

Cluster Randomised ◽

Inappropriate Medications

IntroductionPrescribing of potentially inappropriate medications (PIMs) has become a prominent issue of public concern among elderly patients. However, no research has involved interventions on PIMs of Chinese elderly patients seeking care at primary healthcare. This study aims to evaluate the effectiveness of a tailored educational intervention programme for general practitioners (GPs), aiming at reducing the occurrence of PIMs in elderly patients.Methods and analysisThis is a parallel group, controlled, cluster-randomised trial, with blinded evaluation of outcomes and data analysis, and un-blinded intervention. Twenty primary community healthcare stations (CHSs) in Dongcheng district in Beijing will be randomised to intervention and control arm with an allocation ratio of 1:1. GPs in CHSs randomised to the intervention arm will receive a two-component intervention: general training of PIMs and distribution of PIMs handbook. GPs in the control arm will assess and manage patients according to the institutions’ routine practice. The primary outcome is the change in PIMs patient visit rate.Ethics and disseminationEthics committee approval of this study was obtained from Peking University Institution Review Board (IRB00001052-19074). The findings will be published in scientific and conference presentations.Trial registration numberChiCTR2100047788.

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