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

NCT07587190 — Not applicable, Recruiting, 280 participants, University of Bergen

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Registry	NCT07587190
Status	Recruiting
Phase	Not applicable
Study type	Interventional; non randomized, parallel, masking: none, health services research
Enrollment	280 (Estimated)
Sponsor	University of Bergen (Other); collaborators: University of Zambia
Conditions	Practice Guidelines for Primary Care of Acute Abdomen
Interventions	Practice guidelines for primary care of acute abdomen, No intervention (Other)
Dates	start 2025-09-01, primary completion 2026-08-31 (estimated), completion 2028-12-31 (estimated), first posted 2026-05-14, last updated 2026-05-14
Locations	1 site in Zambia

-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.

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+Arms and interventions

Arm	Type	Interventions	Description
Intervention site	Experimental	Other: Practice guidelines for primary care of acute abdomen	The intervention site will have the guidelines for acute abdomen implemented
Control site	Active comparator	Other: No intervention	The control site will not have the guidelines implemented

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.
No intervention (Other): The control site will receive no intervention.

+Outcome measures

Primary outcomes

Length of Hospital Stay [7 days]: The duration of time in days that a patient with acute abdomen stays in the hospital from the day of admission to discharge

+Eligibility

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* 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.

Exclusion Criteria:

* 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.

+Locations (1)

Facility	City	Country	Status
Kanyama First Level Hospital and Matero First Level Hospital	Lusaka, Lusaka Province	Zambia	Recruiting

+Investigators

Elisabeth Marie Strømme, MD, PhD, Study director, University of Bergen
Thomas Mildestvedt, MD, PhD, Study director, University of Bergen
Eivind Meland, Study director, University of Bergen
Mpundu Makasa, Study director, University of Zambia