Journal article
Effectiveness of a Bundled Intervention Including Adjunctive Corticosteroids on Outcomes of Hospitalized Patients with Community-Acquired Pneumonia: A Stepped-Wedge Randomized Clinical Trial
M Lloyd, A Karahalios, E Janus, EH Skinner, T Haines, A De Silva, S Lowe, M Shackell, S Ko, L Desmond, H Karunajeewa
JAMA Internal Medicine | AMER MEDICAL ASSOC | Published : 2019
Abstract
Importance: Community-acquired pneumonia remains a leading cause of hospitalization, mortality, and health care costs worldwide. Randomized clinical trials support the use of adjunctive corticosteroids, early progressive mobilization, antibiotic switching rules, and dietary interventions in improving outcomes. However, it is uncertain whether implementing these interventions will translate into effectiveness under routine health care conditions. Objective: To evaluate the effectiveness of a bundle of evidence-supported treatments under conditions of routine care in a representative population hospitalized for community-acquired pneumonia. Design, Setting, and Participants: A double-blind, st..
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Funding Acknowledgements
This study received funding from grant number EJWH2015163 from the HCF Research Foundation. Western Health, the University of Melbourne, and Monash University provided salary support to the investigators. Dr Karunajeewa was supported by an Australian National Health and Medical Research Council Career Development Fellowship. Ms Lloyd was supported by an Australian Government Research Training Scheme Scholarship.