Effect of a Multifaceted Educational Intervention on the Implementation of Evidence-based Practices for Benign Paroxysmal Positional Vertigo in an Emergency Department

NCT06314581 | Active Not Recruiting

• 1 other identifier: 673_BPPV-Teaching
• Study Type: observational
• Target: 382
• Locations: 1 country
• Sites: 1

Brief Summary

Acute vertigo accounts for around 4% of emergency room visits. Triggered episodic vestibular syndrome is the most commonly encountered symptomatic context. BPPV (Benign Paroxysmal Positional Vertigo) is the main cause, representing 40-50% of the vertigo cases assessed in emergency departments. It results from the migration of calcium carbonate particles (otoliths), from the sticky membrane of the utricle and saccule of the inner ear, to one of the 3 semicircular canals (SCC), posterior, horizontal or lateral, and anterior. It occurs idiopathically with head movement, through degeneration, or following head trauma. The otolith impulse causes the endolymph to move, temporarily and aberrantly displacing the cup of the affected canal, resulting in the transmission of erroneous information to the vestibular nuclei. This leads to the sudden onset of vertigo and eye deviation, resulting in transient nystagmus. The location of the displaced otoliths determines the variant of BPPV: BPPV of the posterior semicircular canal is the most common (around 65% of BPPVs), followed by BPPV of the horizontal canal, while BPPV of the anterior canal is rare, as it resolves spontaneously and rapidly. Although a benign condition, BPPV leads 9 times out of 10 to a medical consultation, interruption of daily activities, or sick leave. Untreated, it will usually recur, and can impact on patients' quality of life.

Conditions

Benign Paroxysmal Positional Vertigo

Outcome Measures

Primary Outcomes (1)

• accurate BPPV diagnostics

  Percentage of appropriate BPPV diagnoses, i.e., positive diagnostic tests obtained with eligible patients, before and after the educational intervention. Positive diagnostic tests for BPPV are defined as follows: * A Dix-Hallpike test producing triggered and transient, vertical and torsional nystagmus or isolated transient and paroxysmal vertigo (subjective BPPV) on the affected side for the appropriate diagnosis of posterior BPPV, * A Supine Head Roll test producing a triggered and transient horizontal, geotropic or agiotropic nystagmus observed on both sides, but more intense on the healthy side, for the appropriate diagnosis of horizontal BPPV.

  one year

Secondary Outcomes (2)

• therapeutic maneuvers performed

  1 year

• Satisfaction of clinicians who received the educational interventio

  one year

Study Arms (1)

BPPV

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patient older than 18 , visiting the emergency room for vertigo

You may qualify if:

• age \>18
• A triggered episodic vestibular syndrome defined by vertigo that may be associated with nausea or vomiting, brief (\< 1 minute) and transient, triggered by changes in head or body position;
• Or brief episodes of vertigo with no obvious cause and no spontaneous nystagmus.
• French speaking

You may not qualify if:

• Existence of one or more BPPV diagnostic non-compliance criteria i.e. impaired alertness (Glasgow Coma Score \<15), nystagmus present in spontaneous or lateral gaze (without or with Frenzel glasses), headache or neck pain, hypoacusis concomitant with vertigo, any central neurological sign, otalgia, tinnitus, alcohol intoxication;
• Existence of one or more contraindications to performing the Dix-Hallpike test, i.e. vertebro-basilar insufficiency, recent fracture or dislocation of a cervical vertebra, cervical arthritis, recent cervical surgery, history of sino-carotid syncope;
• Patient under court protection;
• Patient under guardianship or curatorship;
• Patient deprived of liberty;
• Patients who object to the use of their data.

Sponsors & Collaborators

• Fondation Hôpital Saint-Joseph: lead

Study Sites (1)

Groupe Hospitalier Paris Saint-Joseph

Paris, 75014, France

Location

MeSH Terms

Conditions

Benign Paroxysmal Positional Vertigo

Condition Hierarchy (Ancestors)

Vertigo; Vestibular Diseases; Labyrinth Diseases; Ear Diseases; Otorhinolaryngologic Diseases; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 11, 2024
• First Posted: March 18, 2024
• Study Start: May 1, 2023
• Primary Completion: May 1, 2024
• Study Completion: December 1, 2024
• Last Updated: May 30, 2024

Record last verified: 2024-05

Locations

FR (1)