Reduction of the long-term use of proton pump inhibitors by a patient-oriented electronic decision support tool (arriba-PPI): study protocol for a randomized controlled trial.
Clinical Decision-Making
Decision Making, Shared
Decision Support Systems, Clinical
Decision Support Techniques
Deprescriptions
Drug Administration Schedule
General Practitioners
Germany
Health Communication
Humans
Physician-Patient Relations
Proton Pump Inhibitors
/ administration & dosage
Randomized Controlled Trials as Topic
Therapy, Computer-Assisted
Time Factors
Treatment Outcome
Computerized clinical decision support system
Deprescribing
Evidence-based medicine
General practitioner
Proton pump inhibitors
Journal
Trials
ISSN: 1745-6215
Titre abrégé: Trials
Pays: England
ID NLM: 101263253
Informations de publication
Date de publication:
21 Nov 2019
21 Nov 2019
Historique:
received:
05
07
2019
accepted:
13
09
2019
entrez:
23
11
2019
pubmed:
23
11
2019
medline:
18
6
2020
Statut:
epublish
Résumé
Proton pump inhibitors (PPIs) are increasingly being prescribed, although long-term use is associated with multiple side effects. Therefore, an electronic decision support tool with the aim of reducing the long-term use of PPIs in a shared decision-making process between general practitioners (GPs) and their patients has been developed. The developed tool is a module that can be added to the so-called arriba decision support tool, which is already used by GPs in Germany in routine care. In this large-scale cluster-randomized controlled trial we evaluate the effectiveness of this arriba-PPI tool. The arriba-PPI tool is an electronic decision support system that supports shared decision-making and evidence-based decisions around the long-term use of PPIs at the point of care. The tool will be evaluated in a cluster-randomized controlled trial involving 210 GP practices and 3150 patients in Germany. GP practices will be asked to recruit 20 patients aged ≥ 18 years regularly taking PPIs for ≥ 6 months. After completion of patient recruitment, each GP practice with enrolled patients will be cluster-randomized. Intervention GP practices will get access to the software arriba-PPI, whereas control GPs will treat their patients as usual. After an observation period of six months, GP practices will be compared regarding the reduction of cumulated defined daily doses of PPI prescriptions per patient. Our principal hypothesis is that the application of the arriba-PPI tool can reduce PPI prescribing in primary care by at least 15% compared to conventional strategies used by GPs. A positive result implies the implementation of the arriba-PPI tool in routine care. German Clinical Trials Register, DRKS00016364. Registered on 31 January 2019.
Sections du résumé
BACKGROUND
BACKGROUND
Proton pump inhibitors (PPIs) are increasingly being prescribed, although long-term use is associated with multiple side effects. Therefore, an electronic decision support tool with the aim of reducing the long-term use of PPIs in a shared decision-making process between general practitioners (GPs) and their patients has been developed. The developed tool is a module that can be added to the so-called arriba decision support tool, which is already used by GPs in Germany in routine care. In this large-scale cluster-randomized controlled trial we evaluate the effectiveness of this arriba-PPI tool.
METHODS
METHODS
The arriba-PPI tool is an electronic decision support system that supports shared decision-making and evidence-based decisions around the long-term use of PPIs at the point of care. The tool will be evaluated in a cluster-randomized controlled trial involving 210 GP practices and 3150 patients in Germany. GP practices will be asked to recruit 20 patients aged ≥ 18 years regularly taking PPIs for ≥ 6 months. After completion of patient recruitment, each GP practice with enrolled patients will be cluster-randomized. Intervention GP practices will get access to the software arriba-PPI, whereas control GPs will treat their patients as usual. After an observation period of six months, GP practices will be compared regarding the reduction of cumulated defined daily doses of PPI prescriptions per patient.
DISCUSSION
CONCLUSIONS
Our principal hypothesis is that the application of the arriba-PPI tool can reduce PPI prescribing in primary care by at least 15% compared to conventional strategies used by GPs. A positive result implies the implementation of the arriba-PPI tool in routine care.
TRIAL REGISTRATION
BACKGROUND
German Clinical Trials Register, DRKS00016364. Registered on 31 January 2019.
Identifiants
pubmed: 31752978
doi: 10.1186/s13063-019-3728-2
pii: 10.1186/s13063-019-3728-2
pmc: PMC6868794
doi:
Substances chimiques
Proton Pump Inhibitors
0
Types de publication
Clinical Trial Protocol
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
636Subventions
Organisme : Innovationsfond (DE)
ID : 01VSF17025
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