This trial is active, not recruiting.

Condition elderly; renal insufficiency
Treatment computer-assisted decision support
Sponsor Indiana University School of Medicine
Start date January 2005
End date December 2012
Trial size 954 participants
Trial identifier NCT00297869, 0311-04B, 2004 Jahnigen Career Award


The subjects in this study are physicians working in the Wishard Emergency Department. The purpose of this study is to measure the extent to which information technology (i.e.-computers) improves emergency department care. The objective of our study is to evaluate the use of informatics in the emergency department and specifically to determine if computer reminder systems: 1) reduce the number of unsafe medications prescribed to older adults, 2) assist in more safely dosing of medications to adults of all ages, and 3) increase influenza immunization of eligible older patients in the emergency department.

Interventions: The interventions in this study are computer reminders. When releasing patients from the emergency department, physicians currently write all release orders, including prescriptions, on a computer order entry system that is linked to the Regenstrief Medical Record System. The computerized order entry system will be programmed so that physicians randomized (randomly placed) into the intervention group, the group that will receive the intervention, they will receive one of three types of reminders:

1. The medication prescribed is generally considered unsafe for use in older patients. The reminder will then list appropriate alternatives for this medication.

2. The dose of the prescribed medication is excessive and should be adjusted for the patient's creatinine clearance (or kidney function).

3. This patient may be eligible for influenza vaccination.

The physician will then choose to order or disregard the recommendation. The computer system will automatically record what the physician selected to do. The general outcome of interest is the extent to which the electronic reminders successfully improved physician practice in the emergency department setting. This outcome will be compared to physicians who were randomized to the group that did not receive the reminders (the control group).

United States No locations recruiting
Other countries No locations recruiting

Study Design

Allocation randomized
Endpoint classification efficacy study
Intervention model factorial assignment
Masking double blind (subject, caregiver, investigator, outcomes assessor)
Primary purpose treatment
(No Intervention)
Electronic warnings when providers prescribe a potentially inappropriate medication or an excessively dosed medication (based on estimated creatinine clearance)
computer-assisted decision support
Electronic warnings when providers prescribe a potentially inappropriate medication or an excessively dosed medication (based on estimated creatinine clearance)

Primary Outcomes

Proportion of older ED patients who receive a potentially inappropriate medication
time frame: During discharge home from the ED

Secondary Outcomes

Proportion of ED patients who receive an excessive dose of a medication that requires dosage adjustment for renal insufficiency
time frame: During discharge home from the ED

Eligibility Criteria

Male or female participants of any age.

Inclusion Criteria: - The subjects of this study will be physician providers and residents and medical students practicing under the supervision of a faculty emergency physician. Specific study subjects will include emergency medicine faculty physicians; emergency medicine and internal medicine residents; emergency medicine, surgery, and internal medicine interns; and medical students taking care of patients in our emergency department. Exclusion Criteria: - We will not include the members of the research team in this study.

Additional Information

Official title Computer-Assisted Decision Support to Increase the Safety of Prescribing to Older Emergency Department Patients
Principal investigator Kevin M. Terrell, DO, MS
Trial information was received from ClinicalTrials.gov and was last updated in March 2010.
Information provided to ClinicalTrials.gov by Indiana University.