N/A
Completed N=1,146
NUDGE-EHR Replication Trial at Mass General Brigham
Aging · Benzodiazepine Sedative Adverse Reaction · Anticholinergic Adverse Reaction · Adverse Drug Event
Source: ClinicalTrials.gov NCT05538065 ↗
Enrolled (actual)
1,146
Serious AEs
0.0%
Results posted
Apr 2025
Primary outcomePrimary: Change in Inappropriate Prescribing — 106; 145; 122 Participants — p=0.002
Summary
Prescribing of potentially unsafe medications for older adults is extremely common; benzodiazepines and sedative hypnotics are, for example, key drug classes frequently implicated in adverse health consequences for vulnerable older adults, such as confusion or sedation, leading to hospitalizations, falls, and fractures. Fortunately, most of these consequences are preventable. Physicians' lack of awareness of alternatives, ambiguous practice guidelines, and perceived pressure from patients or caregivers are among the reasons why these drugs are used more than might be optimal. Reducing inappropriate use of these drugs may be achieved through decision support tools for providers that are embedded in electronic health record (EHR) systems. While EHR strategies are widely used to support the informational needs of providers, these tools have demonstrated only modest effectiveness at improving prescribing. The effectiveness of these tools could be enhanced by leveraging principles of behavioral economics and related sciences.
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Change in Inappropriate Prescribing |
106; 145; 122 | 0.002 sig |
| SECONDARY Quantity of High-risk Medication Prescribed |
398.6; 422.5; 437.9 | 0.386 |
| SECONDARY Cumulative Lorazepam Milligram Equivalents Prescribed |
238.7; 220.1; 259.7 | 0.657 |
Eligibility Criteria
Inclusion Criteria
- Primary care provider at Mass General Brigham
Providers will receive these EHR tools for their patients who meet the following criteria:
- older adults (aged 65 years or more)
- who have been prescribed at least 90 pills of benzodiazepine or sedative hypnotic in the last 180 days.
Outcomes will be measured on the patient level.
Exclusion Criteria
- N/A
Data sourced from ClinicalTrials.gov (NCT05538065). 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. Informational only — not medical advice.