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

Melanie Lloyd, Amalia Karahalios, Edward Janus, Elizabeth H Skinner, Terry Haines, Anurika De Silva, Stephanie Lowe, Melina Shackell, Soe Ko, Lucy Desmond, Harin Karunajeewa, Monica Turczyniak, Kamya Kameshwar, Ben Stevenson, Parul Bali, Elena Gerstman, Kirsty May

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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Grants

Awarded by HCF Research Foundation


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.