EducationNCT03771482
Education of Providers on Prescribing Best Practices
A study testing Quiztime modules in people with Education, run by Vanderbilt University Medical Center at 1 site in United States.
Trial summary
This study aims to evaluate the impact of spaced education, delivered via a smartphone application, on provider prescribing patterns. Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- Education
- What is being tested?
- Quiztime modules
- Type of treatment
- Injection or infusion, Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 369 participants
- Where
- 1 siteUnited States
- Study dates
- 30 Dec 2019to 15 Jun 2020
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- All inpatient prescribing providers
Who cannot join
- none
Trial locations and contacts
1 site in 1 country.
United States1 site
Vanderbilt University Medical Center
Nashville, Tennessee, 37232
About this study
This study aims to evaluate the impact of spaced education, delivered via a smartphone application, on provider prescribing patterns.
Read the detailed 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.
- Conditions
- Education
- Being tested
- Quiztime modules
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Quiztime modulesBehavioural
Text Messaging or Email system
| Study group | Role | What they receive |
|---|---|---|
| Opioid module first then fluid | Active comparator | The providers in this arm will first receive daily information and questions related to opioid use for eight weeks and then daily information and questions related to intravenous fluid prescribing for five weeks. Receives: Behavioral: Quiztime modules |
| Fluid module first then opioid | Active comparator | The providers in this arm will first receive daily information and questions related to intravenous fluid prescribing for five weeks and then daily information and questions related to opioid use for eight weeks. Receives: Behavioral: Quiztime modules |
What is being measured
The primary outcome is the main question the study is designed to answer.
Median morphine milligram equivalents (MME) per opioid prescription
By extracting prescribing data for opioids from the electronic health records
Measured: 8 months
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
Measured: 8 months
Secondary outcomes (9)
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
Measured: 8 months
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
Measured: 8 months
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
Measured: 30 days
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
Measured: 8 months
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
Measured: 8 months
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
Measured: 8 months
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
Measured: 8 months
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
Measured: 8 months
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
Measured: 8 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted11 Dec 2018
- Study start30 Dec 2019
- Primary completion15 Jun 2020
- Study completion15 Jun 2020
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for EducationStudies of the same condition, open and under way.
- More trials run by Vanderbilt University Medical CenterThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- None (open label)
- Enrolment
- 369 participants (actual)
Sponsor and investigators
- Lead sponsor
- Vanderbilt University Medical Center
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Matthew McEvoy, Vanderbilt University Medical Center
- Investigators
- Matthew McEvoy, MD, Principal investigator, Vanderbilt University Medical Center
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03771482
- Sponsor's protocol ID
- 190371
- Status last verified
- Oct 2020
- First submitted
- 7 Dec 2018
- Last updated
- 14 Oct 2020
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: Data dictionaries and individual participant data that underlie the results reported after de-identification will be available.
Publications
McEvoy MD, Dear ML, Buie R, Edwards DA, Barrett TW, Allen B, Robertson AC, Fowler LC, Hennessy C, Miller BM, Garvey KV, Bland RP 3rd, Fleming GM, Moore D, Rice TW, Bernard GR, Lindsell CJ; Vanderbilt Learning Healthcare System Platform Investigators and the Vanderbilt Committee on Opioid Monitoring and Stewardship. Effect of Smartphone App-Based Education on Clinician Prescribing Habits in a Learning Health Care System: A Randomized Cluster Crossover Trial. JAMA Netw Open. 2022 Jul 1;5(7):e2223099. doi: 10.1001/jamanetworkopen.2022.23099.
PubMed 35881398McEvoy MD, Dear ML, Buie R, Fowler LC, Miller B, Fleming GM, Moore D, Rice TW, Bernard GR, Lindsell CJ; Vanderbilt Learning Healthcare System Investigators. Embedding Learning in a Learning Health Care System to Improve Clinical Practice. Acad Med. 2021 Sep 1;96(9):1311-1314. doi: 10.1097/ACM.0000000000003969.
PubMed 33570841
Study at a glance
From the registry record, last updated by the sponsor on 14 Oct 2020. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Education of Providers on Prescribing Best Practices
- ClinicalTrials.gov ID
- NCT03771482
- Acronym / sponsor ID
- 190371
- Conditions
- Education
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 369 participants (actual)
- Lead sponsor
- Vanderbilt University Medical CenterUniversity, hospital or other
- Study start
- 30 Dec 2019 (actual)
- Primary completion
- 15 Jun 2020 (actual)
- Study completion
- 15 Jun 2020 (actual)
- First posted
- 11 Dec 2018 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study aims to evaluate the impact of spaced education, delivered via a smartphone application, on provider prescribing patterns.
Detailed 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.
Study design
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Opioid module first then fluid | Active comparator | Behavioral: Quiztime modulesThe providers in this arm will first receive daily information and questions related to opioid use for eight weeks and then daily information and questions related to intravenous fluid prescribing for five weeks. |
| Fluid module first then opioid | Active comparator | Behavioral: Quiztime modulesThe providers in this arm will first receive daily information and questions related to intravenous fluid prescribing for five weeks and then daily information and questions related to opioid use for eight weeks. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (1 listed)
- All inpatient prescribing providers
Key exclusion criteria (1 listed)
- none
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Quiztime modulesText Messaging or Email system | Behavioural | Fluid module first then opioid, Opioid module first then fluid |
Primary outcome
Median morphine milligram equivalents (MME) per opioid prescription
Time frame: 8 months
By extracting prescribing data for opioids from the electronic health records
Percentage of orders for balanced intravenous (IV) fluid solutions (i.e. not normal saline)
Time frame: 8 months
By extracting prescribing data for intravenous fluids from the electronic health records
9 secondary outcomes
Chloride levels in patients receiving intravenous fluid orders from a provider enrolled in the study
Time frame: 8 months
Potassium levels in patients receiving intravenous fluid orders from a provider enrolled in the study
Time frame: 8 months
Major Adverse Kidney Events by 30 days (MAKE 30) in patients receiving intravenous fluid orders from a provider enrolled in the study
Time frame: 30 days
Length of stay for patients receiving an intravenous fluid order or an opioid prescription from a provider enrolled in the study.
Time frame: 8 months
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
Time frame: 8 months
Median number of pills per prescription for patients receiving an opioid prescription from a provider enrolled in the study
Time frame: 8 months
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.)
Time frame: 8 months
Percent of opioid prescriptions (discharge) that also had a scheduled (not PRN) non-opioid (APAP, NSAIDs, GABA, muscle relaxant, etc.)
Time frame: 8 months
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)
Time frame: 8 months
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 14 Oct 2020.
- Derived from this study: PubMed 35881398McEvoy MD, Dear ML, Buie R, Edwards DA, Barrett TW, Allen B, Robertson AC, Fowler LC, Hennessy C, Miller BM, Garvey KV, Bland RP 3rd, Fleming GM, Moore D, Rice TW, Bernard GR, Lindsell CJ; Vanderbilt Learning Healthcare System Platform Investigators and the Vanderbilt Committee on Opioid Monitoring and Stewardship. Effect of Smartphone App-Based Education on Clinician Prescribing Habits in a Learning Health Care System: A Randomized Cluster Crossover Trial. JAMA Netw Open. 2022 Jul 1;5(7):e2223099. doi: 10.1001/jamanetworkopen.2022.23099.
- Derived from this study: PubMed 33570841McEvoy MD, Dear ML, Buie R, Fowler LC, Miller B, Fleming GM, Moore D, Rice TW, Bernard GR, Lindsell CJ; Vanderbilt Learning Healthcare System Investigators. Embedding Learning in a Learning Health Care System to Improve Clinical Practice. Acad Med. 2021 Sep 1;96(9):1311-1314. doi: 10.1097/ACM.0000000000003969.
- Individual participant dataSharing planned: Yes. Data dictionaries and individual participant data that underlie the results reported after de-identification will be available.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Matthew McEvoy, MD principal investigator
Vanderbilt University Medical Center
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Quiztime modules in people with Education, run by Vanderbilt University Medical Center at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 14 Oct 2020. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Median morphine milligram equivalents (MME) per opioid prescription (time frame: 8 months). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03771482, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Oct 2020.