Education of Providers on Prescribing Best Practices

Education Clinical Trial

Official title:

Education of Providers on Prescribing Best Practices

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03771482
• Other study ID #: 190371
• Status: Completed
• Phase: N/A
• Start date: December 30, 2019
• Est. completion date: June 15, 2020

Study information

• Verified date: October 2020
• Source: Vanderbilt University Medical Center
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This study aims to evaluate the impact of spaced education, delivered via a smartphone application, on provider prescribing patterns.

Description:

As part of a medical center educational initiative at Vanderbilt University Medical Center (VUMC), two educational modules will be sent to prescribing providers through either email or short message service (SMS) text messaging. The first educational module consists of a set of multiple choice questions concerning best practices for prescribing intravenous fluids in the inpatient and perioperative setting. This module is based upon recent literature and specifically derived from the results of the Isotonic Solutions and Major Adverse Renal Events Trial (SMART) and Saline Against Lactated Ringer's or Plasma-Lyte in the Emergency Department (SALT-ED) trial, both published in the New England Journal of Medicine in 2018 and led by Vanderbilt investigators. Similarly, a second educational module concerning evidence-based pain management and opioid prescribing practices will be distributed via email or SMS text messaging.

Participants will receive one question per day. If the participant does not answer the question correctly, they will receive the opportunity to attempt the question again after reviewing evidence-based education. All questions have been curated and reviewed by a panel of experts and piloted within VUMC for feasibility and acceptability. Key concepts are repeated in each module and questions are strategically ordered throughout each module to accomplish spaced education.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 369
• Est. completion date: June 15, 2020
• Est. primary completion date: June 15, 2020
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• All inpatient prescribing providers

Exclusion Criteria:

• none

Related Conditions & MeSH terms

• Education

Intervention

Behavioral:
• Quiztime modules
Text Messaging or Email system

Locations

Country	Name	City	State
United States	Vanderbilt University Medical Center	Nashville	Tennessee

Sponsors (1)

Lead Sponsor	Collaborator
Vanderbilt University Medical Center

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Median morphine milligram equivalents (MME) per opioid prescription	By extracting prescribing data for opioids from the electronic health records	8 months
Primary	Percentage of orders for balanced intravenous (IV) fluid solutions (i.e. not normal saline)	By extracting prescribing data for intravenous fluids from the electronic health records	8 months
Secondary	Chloride levels in patients receiving intravenous fluid orders from a provider enrolled in the study	By extracting chloride level data from the electronic health records	8 months
Secondary	Potassium levels in patients receiving intravenous fluid orders from a provider enrolled in the study	By extracting potassium level data from the electronic health records	8 months
Secondary	Major Adverse Kidney Events by 30 days (MAKE 30) in patients receiving intravenous fluid orders from a provider enrolled in the study	By extracting data from the electronic health records	30 days
Secondary	Length of stay for patients receiving an intravenous fluid order or an opioid prescription from a provider enrolled in the study.	By extracting length of stay data from the electronic health records	8 months
Secondary	Length of stay in the intensive care unit (ICU) for patients receiving an intravenous fluid order or an opioid prescription from a provider enrolled in the study	By extracting ICU length of stay from the electronic health records	8 months
Secondary	Median number of pills per prescription for patients receiving an opioid prescription from a provider enrolled in the study	By extracting medication data from the electronic health records	8 months
Secondary	Percent of opioid prescriptions (inpatient) that also had a scheduled (not pro re nata (PRN)) non-opioid (APAP, nonsteroidal anti-inflammatory drugs (NSAIDs), gamma-Aminobutyric acid (GABA), muscle relaxant, etc.)	By extracting medication data from the electronic health records	8 months
Secondary	Percent of opioid prescriptions (discharge) that also had a scheduled (not PRN) non-opioid (APAP, NSAIDs, GABA, muscle relaxant, etc.)	By extracting medication data from the electronic health records	8 months
Secondary	Number of Rapid Response Team calls (RRT s) indexed to the number of patients cared for per prescriber (evaluated by level of engagement of the learner with QuizTime)	By extracting RRT calls from the electronic health records	8 months