Grant: Project Grant

To understand if treatments such as drugs or procedures effect patient outcomes (e.g. symptoms, quality of life, survival), medical researchers conduct studies comparing outcomes of patients that receive the treatment to outcomes of patients that do not. However, because many treatments are complex (involve multiple parts and/or people), it can be difficult to understand the meaning of study results due to local differences influencing the way the treatment being studied was introduced and delivered. A process evaluation is a type of study that occurs alongside the main study and enables understanding of factors influencing how a treatment was introduced and maintained over the duration of a study as well as how much of the treatment was delivered as planned. We will conduct a process evaluation of a multi-centre study studying if a regimen of antibiotics (drugs that kill bugs) given to prevent rather than treat an infection to critically ill adults during admission to an intensive care unit (ICU) reduces death, antibiotic usage, and antibiotic resistance rates (drug is no longer effective for a certain infection) - The SuDDICU study. We will conduct surveys, interviews, audits, and observe practice in ICUs taking part in the trial to understand: (1) how the treatment was introduced at each ICU and maintained over time; (2) if the treatment was delivered as planned; and (3) what this information can tell us to understand the results of the main trial. Our process evaluation will enable us to better understand if these preventative antibiotics saves lives and reduces antibiotic usage as well as the impact on antibiotic resistance. It also will give us information about whether we could expect the same findings if we introduced the intervention into other ICUs after the study and how best to do this.