Optimizing Stroke Prophylaxis of Acute Atrial Fibrillation With an Electronic Clinical Decision Support Tool

Part of paid clinical trials in Portland, Oregon.

Sponsor
Oregon Health and Science University
Study ID
NCT05341986
Status
Enrolling By Invitation

Conditions

Eligibility Criteria

Sex
ALL
Age
18 Years - N/A
Healthy Volunteers
Not accepted

Interventions

  • Clinical Decision Support (CDS) tool — OTHER
    Implementation of an EHR-based CDS tool for providers to use.

Study Details

Atrial fibrillation (AF) is the most common arrhythmia in the world, with significant morbidity and mortality. With appropriate oral anticoagulation, the risk of stroke due to atrial fibrillation decreases by 64%. Although atrial fibrillation is commonly diagnosed and treated in the Emergency Department (ED), oral anticoagulation is significantly underprescribed. Underprescribing has been attributed to a lack of empowerment and deferral of prescribing to longitudinal care clinicians. Using a convergent parallel quantitative-qualitative design (mixed-methods), we propose a stepped-wedge cluster randomized trial design with the implementation of a clinical decision support (CDS) tool in adults with new-onset AF that are OAC-naïve and at significant risk for stroke. In parallel, we will use qualitative approaches to evaluate clinician facilitators and barriers to tool utilization as well as patient satisfaction and engagement with the tool.

Key Dates

Start date
Jan 11, 2022
Status verified
Mar 2025
Primary completion
Mar 1, 2026
Completion
May 1, 2026

Study Design

Enrollment
36 participants (estimated)
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER

Arms

  • Other: Link-Out
    Clinicians will be trained on the web-based portal of the CDS tool and shown where the Link to the tool will be available in the EHR.
  • Other: BPA + Link-out
    Clinicians will be trained on how a BPA is triggered when a patient is diagnosed with AF. The alert will pop up within the EHR with the Link-out to the web portal.
  • Other: BPA + FHIR
    Instead of a link to the web-based portal, the BPA will contain a link to the FHIR-integrated CDS tool portal. FHIR will automatically pull EHR data about the patient into the CDS tool portal. Data include demographic information, comorbidities in the active problem list, past medical and surgical history, and social history. Clinicians will also receive training before the implementation of this step.

Primary Outcome Measure

Number of patients appropriately prescribed OACs after CDS tool implementation. [ Time Frame: through study completion, up to 4 years ]

Locations (1)

FacilityCityStateZIPSite coordinators
Oregon Health & Science University (OHSU)PortlandOregon97239-

Find similar trials in Portland, OR

By condition
Atrial fibrillation
By specialty
CardiologyHeart disease
By research site
Oregon Health & Science University (OHSU)· Portland, OR

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