Effectiveness of Implementing the Adapted Practice Guidelines for Primary Care of Acute Abdomen in Zambia: An Effectiveness-Implementation Hybrid Type 2 Study Design.

NCT07587190 | Recruiting

• 1 other identifier: REK Ref No: 576758
• Study Type: interventional
• Target: 280
• Locations: 1 country
• Sites: 1

Brief Summary

The study aims 1) to adapt, 2) to develop implementation strategies for and 3) to evaluate the effect of implementing a practice guideline for acute abdomen at primary care level in Zambia. We employ a sequential exploratory mixed method study design. Qualitative and quantitative data from health care workers will be used to adapt a practice guideline developed in a high-income into a low- and middle-income (LMIC) context and to develop strategies for successful implementation. The primary outcome of interest is the prospective change in length of stay in hospital among patients presenting with acute abdomen in the intervention site compared to the control site. The study will address the scarcity of literature on practice guidelines for acute abdomen in the LMIC context. The implementation of an adapted guideline may contribute to a reduction of the morbidity and mortality rates associated with acute abdomen in this setting by increasing management capacity at the primary care level.

Conditions

Practice Guidelines for Primary Care of Acute Abdomen

Keywords

Acute Abdomen, Practice guidelines, Primary Health Care, Adaptation, Implementation Strategies, Effectiveness-Implementation Hybrid Type 2 Study Design

Outcome Measures

Primary Outcomes (1)

• Length of Hospital Stay

  The duration of time in days that a patient with acute abdomen stays in the hospital from the day of admission to discharge

  7 days

Study Arms (2)

Intervention site

EXPERIMENTAL

The intervention site will have the guidelines for acute abdomen implemented

Other: Practice guidelines for primary care of acute abdomen

Control site

ACTIVE COMPARATOR

The control site will not have the guidelines implemented

Other: No intervention

Interventions

Practice guidelines for primary care of acute abdomen OTHER

Adjusted practice guidelines for primary care of acute abdomen will be implemented at the intervention site.

Intervention site

No intervention OTHER

The control site will receive no intervention.

Control site

Eligibility Criteria

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

You may qualify if:

• Data from all patients 18 year and older with acute abdomen including surgical, gynecological and medical acute abdomen managed at the intervention site and control site will be collected during the study period.

You may not qualify if:

• All cases of acute abdomen secondary to trauma will be excluded from the study. All patients in the immediate postoperative phase operated from other facilities presenting with acute abdomen.

Sponsors & Collaborators

• University of Bergen: lead
• University of Zambia: collaborator

Study Sites (1)

Kanyama First Level Hospital and Matero First Level Hospital

Lusaka, Lusaka Province, 10101, Zambia

RECRUITING

MeSH Terms

Conditions

Abdomen, Acute

Interventions

Practice Guidelines as Topic

Condition Hierarchy (Ancestors)

Abdominal Pain; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Signs and Symptoms, Digestive

Intervention Hierarchy (Ancestors)

Guidelines as Topic; Quality Assurance, Health Care; Quality of Health Care; Health Services Administration; Health Care Quality, Access, and Evaluation

Study Officials

• Elisabeth Marie Strømme, MD, PhD

  University of Bergen

  STUDY DIRECTOR

• Thomas Mildestvedt, MD, PhD

  University of Bergen

  STUDY DIRECTOR

• Eivind Meland

  University of Bergen

  STUDY DIRECTOR

• Mpundu Makasa

  University of Zambia

  STUDY DIRECTOR

Central Study Contacts

Wilson Mbewe, MD

CONTACT

+260977466316; wimbe8573@uib.no

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: May 8, 2026
• First Posted: May 14, 2026
• Study Start: September 1, 2025
• Primary Completion (Estimated): August 31, 2026
• Study Completion (Estimated): December 31, 2028
• Last Updated: May 14, 2026

Record last verified: 2025-08

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL

Locations

ZA (1)