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Trial registered on ANZCTR
Registration number
ACTRN12623001340628
Ethics application status
Approved
Date submitted
23/11/2023
Date registered
19/12/2023
Date last updated
31/05/2024
Date data sharing statement initially provided
19/12/2023
Type of registration
Prospectively registered
Titles & IDs
Public title
A cluster-randomised controlled trial, implementing CONn Syndrome screening and Evaluation in Primary care (CONSEP)
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Scientific title
A cluster-randomised controlled trial evaluating the impact of guidance-based requests on screening and diagnosis rates of CONn syndrome in primary care
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Secondary ID [1]
310953
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MRFF2022933
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Universal Trial Number (UTN)
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Trial acronym
CONSEP
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Hypertension
332033
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Condition category
Condition code
Cardiovascular
328761
328761
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0
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Hypertension
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Metabolic and Endocrine
328981
328981
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0
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Other endocrine disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
After randomization, baseline data will be extracted from Best Practice software, and the Provider Survey will be conducted. After completing the above steps, our intervention will take place.
Practices in the intervention arm will receive:
1. A brief 20-30 minutes introduction to CONSEP trial and primary aldosteronism (PA) screening. This introduction will be presented in each practice, participating general practitioners and/or relevant staff can attend face to face, via an online meeting software, or via watching recordings of the education. Presentation slides is made specific for this study based on the latest Harmonisation of Endocrine Dynamic Testing -Adult (HEDTA) states. Printouts will be provided during the presentation, and a webpage link will be provided after the presentation. A research staff from the CONSEP team will administer this intervention. A session attendance checklist will be used to monitor adherence to the intervention.
2. Guided-based requests (GBR) software activation and user education. GBR is a four-step method for ordering consistent pathology tests for common clinical contexts based on existing guidelines. GBR will be activated at the practice. And a brief 10-20 minutes user education presentation will be presented in each practice right after the presentation of introduction to CONSEP trial and PA screening. Similarly, participating general practitioners and/or relevant staff can attend face to face, via an online meeting software, or via watching recordings of the education. Presentation slides made for new GBR users will be used for the presentation, printouts will be provided during the presentation, and online video link will be provided after the presentation. A staff from Sonic Pathology will administer this intervention. A session attendance checklist will be used to monitor adherence to the intervention.
3. An audit of aldosterone to renin ratio (ARR) test ordering and GBR usage after 3 months after the commencement of intervention. The practice manager or a delegated practice staff will assist with this audit.
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Intervention code [1]
327392
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Early detection / Screening
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Comparator / control treatment
Practices in the control arm will receive a brief introduction to CONSEP trial and PA screening, and audit of ARR test ordering.
The brief introduction to CONSEP trial and PA screening will be the same as the intervention arm. And the audit of aldosterone to renin ratio (ARR) test ordering will happen at 3 months after the commencement of intervention. The practice manager or a delegated practice staff will administer this audit. A research staff from the CONSEP team may also help to administer this audit.
The only two differences between the practices in the control arm and the intervention arm are that those in the control arm do not receive GBR (part 2 in the intervention arm), and the audit of GBR using (part of part 3 in the intervention arm).
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Control group
Active
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Outcomes
Primary outcome [1]
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Proportion of eligible patients screened for primary aldosteronism
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Assessment method [1]
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data extraction from Best Practice software
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Timepoint [1]
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12 months after the commencement of intervention
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Primary outcome [2]
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Proportion of eligible patients diagnosed with primary aldosteronism
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Assessment method [2]
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Data extraction from Best Practice software
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Timepoint [2]
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24 months after the commencement of intervention
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Secondary outcome [1]
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Rates of blood pressure control in eligible patients.
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Assessment method [1]
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Data extraction from Best Practice software
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Timepoint [1]
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12 and 24 months after the commencement of intervention
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Secondary outcome [2]
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The amount (dose and frequency) of antihypertensive medication use in eligible patients.
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Assessment method [2]
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Data extraction from Best Practice software
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Timepoint [2]
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12 and 24 months after the commencement of intervention
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Secondary outcome [3]
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Evaluate the barriers and enablers to the process of implementing the intervention to increase the screening and diagnosis of primary aldosteronism
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Assessment method [3]
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30 minutes audio-recorded semi-structured interview conducted by members of the research team.
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Timepoint [3]
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12 months after the commencement of intervention
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Secondary outcome [4]
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the cost of the intervention
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Assessment method [4]
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research notes (such as the printing cost and mailing cost of the recruitment materials)
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Timepoint [4]
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during the preparation and delivery of intervention
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Eligibility
Key inclusion criteria
To be eligible, practices will:
(1) use Best PracticeTM Clinical Management Software;
(2) be accredited;
(3) provide general primary care services;
(4) plan to be in operation for the next 2 years;
(5) use Sonic Pathology (Melbourne Pathology in VIC, Clinpath Pathology in SA, Hobart Pathology in TAS) as default pathology;
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
To be eligible, practices need to be not:
(1) practices recruited for our prior educational intervention;
(2) practices which are previous users, current users or planning to use Guidance-based requests (GBR) to order pathology tests in the next 2 years;
(3) practices which share their database with other practices.
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Study design
Purpose of the study
Educational / counselling / training
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
central randomisation by computer
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
block randomisation
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
14/06/2024
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Actual
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Date of last participant enrolment
Anticipated
30/08/2024
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Actual
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Date of last data collection
Anticipated
30/10/2026
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Actual
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Sample size
Target
840
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Accrual to date
0
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Final
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Recruitment in Australia
Recruitment state(s)
SA,TAS,VIC
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Department of Health and Aged Care - Medical Research Future Fund (MRFF)
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Address [1]
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414 La Trobe St, Melbourne VIC 3000
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Country [1]
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Australia
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Primary sponsor type
Government body
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Name
Department of Health and Aged Care
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Address
414 La Trobe St, Melbourne VIC 3000
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
317305
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Country [1]
317305
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
314137
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Monash University Human Research Ethics Committee
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Ethics committee address [1]
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Building 3e, Room 111 Research Office Monash University VIC 3800
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Ethics committee country [1]
314137
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Australia
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Date submitted for ethics approval [1]
314137
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10/08/2023
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Approval date [1]
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16/08/2023
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Ethics approval number [1]
314137
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Summary
Brief summary
Missing a diagnosis of primary aldosteronism (PA) leads to adverse patient outcomes above and beyond hypertension. A simple blood test is available to screen for this common and potentially curable condition, but is severely under-utilised. Interventions including education and clinical decision support are likely to increase PA screening in primary care where the vast majority of hypertensive patients are managed. A well-powered trial that incorporates strong implementation strategies and health economic analyses is what we are proposing to address the issue.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Jun Yang
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Address
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Hudson Institute of Medical Research. 27-31 Wright St, Clayton VIC 3168.
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Country
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Australia
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Phone
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+61 3 8572 2540
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Linghan Jia
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Address
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Hudson Institute of Medical Research. 27-31 Wright St, Clayton VIC 3168
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Country
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Australia
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Phone
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+61 3 8572 2700
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Jun Yang
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Address
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Hudson Institute of Medical Research. 27-31 Wright St, Clayton VIC 3168
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Country
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Australia
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Phone
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+61 3 8572 2540
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Fax
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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