Grande Prairie

Researchers are investigating a treatment approach for patients hospitalized with community-acquired pneumonia (CAP), a condition with high rates of illness and death. This phase 3 trial compares therapeutic-dose heparin versus usual care pharmacological thromboprophylaxis to see if it improves patient outcomes. The study focuses on preventing complications caused by blood clots and inflammation that can worsen respiratory and organ function in CAP patients. Previous findings in COVID-19 pneumonia suggest heparin might reduce disease progression and mortality, but its effects in non-COVID-19 CAP are unknown. Participants will receive either therapeutic-dose heparin, preferably a low molecular weight heparin (LMWH) like enoxaparin, dalteparin, or tinzaparin, dosed by patient weight unless contraindicated. Intravenous unfractionated heparin (UFH) may be used instead, especially for those with kidney issues, with dosing adjusted to specific blood clotting targets. The trial is open-label and randomized, with adaptive rules to monitor progress. Usual care pharmacological thromboprophylaxis is the comparator. Treatment and monitoring occur during hospital admission, anticipated to last at least 72 hours after randomization. During the study, patients are assessed for survival at 30 days and monitored for complications related to CAP. Researchers collect clinical data including oxygen use, laboratory tests, and adverse events, tracking safety and effectiveness. The study excludes patients with active COVID-19, recent bleeding, contraindications to anticoagulation, or those receiving critical care interventions. Overall participation depends on hospital stay length and clinical status, with follow-up to evaluate the primary outcome of survival within a month.

Researchers are evaluating a standardized pathway for delivering acute renal replacement therapy (RRT) in intensive care units (ICUs) across Alberta. The goal is to reduce program and healthcare system costs while improving important patient-reported outcomes for patients with acute renal injury. This effort addresses the current lack of a uniform approach to prescribing and delivering acute dialysis therapy in ICUs. The study involves implementing evidence-based best practices through quarterly key performance indicator (KPI) reports and individualized prescriber reports. These prescriber reports focus on initiation patterns of acute RRT and include targeted education to align treatment with best evidence-based practices. The program covers all patients receiving acute dialysis therapy in 15 adult and 3 pediatric ICUs in Alberta during the intervention period. Participants will receive acute RRT as part of their usual care. Researchers will monitor key performance indicators throughout the intervention period, lasting up to three years, and evaluate health system costs over the same time frame. The study aims to improve the delivery of acute dialysis therapy while ensuring safety and cost-effectiveness in critically ill patients.

Researchers are evaluating a new child-focused goal-setting approach called ENGAGE in pediatric rehabilitation for children aged 5 to 12 years with neurodevelopmental disabilities such as autism spectrum disorder and cerebral palsy. The study aims to see if ENGAGE improves children's engagement in therapy, their goal performance and satisfaction, functional abilities, participation at home, school, or community, and quality of life for both children and caregivers. It also examines cost-effectiveness and service use compared to usual therapy practices. The study uses a pragmatic cluster randomized controlled trial design involving 24 therapists at six sites in Alberta, Canada. Therapists are randomized to either the ENGAGE intervention group, where they receive training on a principles-based goal-setting approach and strategies, or a control group receiving usual care. Treatment varies from 3 to 8 sessions over 2 to 8 weeks based on goals and family preferences. The ENGAGE therapists are monitored for adherence to the approach before recruiting children, and both groups document treatment details and co-interventions throughout the study. Children participate in assessments at three times: before treatment, within 10 days after completing therapy, and three months post-treatment. The primary outcome is goal performance and satisfaction measured by the Canadian Occupational Performance Measure (COPM). Additional evaluations include parent and child quality of life, therapy session costs, and service utilization. Qualitative interviews with children, parents, and therapists explore factors influencing ENGAGE implementation. Data analysis compares changes between groups over time to assess effectiveness and cost-benefit.