Trial reportBMJ (Clinical research ed.)2005
Effect of educational outreach to nurses on tuberculosis case detection and primary care of respiratory illness: pragmatic cluster randomised controlled trial.
Trial report in BMJ (Clinical research ed.), 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 75 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
75 citing papers in PubMed, 7 syntheses or guidelines pooled it, 173 citations in OpenAlex.
- Improving cascade outcomes for active TB: A global systematic review and meta-analysis of TB interventions.PLoS medicine · 2023Pooled it
- Educational interventions for health professionals managing chronic obstructive pulmonary disease in primary care.The Cochrane database of systematic reviews · 2022Pooled it
- Use and effects of implementation strategies for practice guidelines in nursing: a systematic review.Implementation science : IS · 2021Pooled it
- The 'Practical Approach to Lung Health' in sub-Saharan Africa: a systematic review.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2016Pooled it
- Adjunctive steroid therapy for managing pulmonary tuberculosis.The Cochrane database of systematic reviews · 2014Pooled it
- Active case finding in contacts of people with tuberculosis.The Cochrane database of systematic reviews · 2011Pooled it
- Strategies for integrating primary health services in low- and middle-income countries at the point of delivery.The Cochrane database of systematic reviews · 2011Pooled it
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- Effectiveness of educational outreach in infectious diseases management: a cluster randomized trial in Uganda.BMC public health · 2016Trial
- Three methods of delivering clinic-based training on syndromic management of sexually transmitted diseases in South Africa: a pilot study.Sexually transmitted infections · 2016Trial
- A knowledge translation intervention to improve tuberculosis care and outcomes in Malawi: a pragmatic cluster randomized controlled trial.Implementation science : IS · 2015Trial
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- Strengthening contact tracing capacity of pulmonary tuberculosis patients in Enugu, southeast Nigeria: a targeted and focused health education intervention study.BMC public health · 2014Trial
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- Comparison of two methods for acquisition of sputum samples for diagnosis of suspected tuberculosis in smear-negative or sputum-scarce people: a randomised controlled trial.The Lancet. Respiratory medicine · 2013Trial
- Task shifting of antiretroviral treatment from doctors to primary-care nurses in South Africa (STRETCH): a pragmatic, parallel, cluster-randomised trial.Lancet (London, England) · 2012Trial
- Task shifting and integration of HIV care into primary care in South Africa: the development and content of the streamlining tasks and roles to expand treatment and care for HIV (STRETCH) intervention.Implementation science : IS · 2011Trial
15 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Erratum issuedMyers, Pat [corrected to Mayers, Pat]
Authors and funding
14 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo develop and implement an educational outreach programme for the integrated case management of priority respiratory diseases (practical approach to lung health in South Africa; PALSA) and to evaluate its effects on respiratory care and detection of tuberculosis among adults attending primary care clinics.
designPragmatic cluster randomised controlled trial, with clinics as the unit of randomisation.
setting40 primary care clinics, staffed by nurse practitioners, in the Free State province, South Africa.
participants1999 patients aged 15 or over with cough or difficult breathing (1000 in intervention clinics, 999 in control clinics).
interventionBetween two and six educational outreach sessions delivered to nurse practitioners by usual trainers from the health department. The emphasis was on key messages drawn from the customised clinical practice guideline for the outreach programme, with illustrative support materials.
main outcome measuresSputum screening for tuberculosis, tuberculosis case detection, inhaled corticosteroid prescriptions for obstructive lung disease, and antibiotic prescriptions for respiratory tract infections.
resultsAll clinics and almost all patients (92.8%, 1856/1999) completed the trial. Although sputum testing for tuberculosis was similar between the groups (22.6% in outreach group v 19.3% in control group; odds ratio 1.22, 95% confidence interval 0.83 to 1.80), the case detection of tuberculosis was higher in the outreach group (6.4% v 3.8%; 1.72, 1.04 to 2.85). Prescriptions for inhaled corticosteroids were also higher (13.7% v 7.7%; 1.90, 1.14 to 3.18) but the number of antibiotic prescriptions was similar (39.7% v 39.4%; 1.01, 0.74 to 1.38).
conclusionsCombining educational outreach with integrated case management provides a promising model for improving quality of care and control of priority respiratory diseases, without extra staff, in resource poor settings.
trial registrationCurrent controlled trials ISRCTN13438073.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.