N/A
N=158
An Electronic Clinical Decision Support Tool to Reduce Low-value Antipsychotic Prescriptions
Alzheimer Disease · Dementia Alzheimers · Dementia of Alzheimer Type
Bottom Line
View on ClinicalTrials.gov: NCT04851691 ↗Enrolled (actual)
158
Serious AEs
8.9%
Results posted
Sep 2024
Primary outcome: Primary: Cumulative Total of New Antipsychotic Pill-days Prescribed — 12569; 25916 New antipsychotic prescription days
Study Design & Population
- Study type
- Interventional
- Phase
- N/A
- Interventions
- EHR CDS (Behavioral); Usual Care (Other)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- University of California, Los Angeles
- Primary completion
- Apr 2023
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Cumulative Total of New Antipsychotic Pill-days Prescribed |
12569; 25916 | — |
| SECONDARY Number of Patients Who Receive Handout |
0; 0 | — |
| SECONDARY Number of Patients With ER Visit |
— | — |
| SECONDARY Number of Patients With Hospitalization |
— | — |
| SECONDARY Hospitalizations (Including Psychiatric Hospitalizations) |
— | — |
| SECONDARY Death Within 90 Days After Enrollment |
— | — |
Summary
The goal of this study will be to design, implement and test the impact of a quality improvement (QI) intervention that uses an EHR CDS tool among physicians newly ordering an antipsychotic medication for older adults with ADRD. The study team hypothesizes that the intervention will reduce each participating clinician's pill days per patient prescribed.
Eligibility Criteria
Inclusion Criteria
- Physicians who will be eligible to receive the EHR CDS tool intervention include those who provide ambulatory care in the UCLA health system and have newly prescribed antipsychotics (e.g., Quetiepine, Olanzapine, Risperidone, Aripiprazole, Haloperidol, Clozapine) for eligible patients (described below) at the medical center in the last 24 months.
- Eligible patients will be enrolled in the study during their first encounter with one of the randomized physicians (see above) during which a new antipsychotic medication order will be initiated. Inclusion criteria for patients will include: 1) having an assigned primary care physician (PCP) and/or assignment to an Accountable Care Organization (ACO) at UCLA Health, and: 2) being part of the health system's EHR-based dementia registry.
Exclusion Criteria
- Patients who have diagnosis codes for schizophrenic disorders, delusion disorders, bipolar disorders, or other non-organic psychoses on their problem list.
- Patients with Parkinson's disease on their problem list
- Patients who have been prescribed antipsychotics in the prior 12 months
Data sourced from ClinicalTrials.gov (NCT04851691). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.