Brief clinician education for Bacteriuria
This study is evaluating whether nudges can help reduce the overuse of tests and treatments in older adults.
See full descriptionAbout the trial for Bacteriuria
Treatment Groups
This trial involves 2 different treatments. Brief Clinician Education is the primary treatment being studied. Participants will all receive the same treatment. There is no placebo group. The treatments being tested are not being studied for commercial purposes.
Eligibility
This trial is for patients born any sex aged 18 and older. There is one eligibility criterion to participate in this trial as listed below.
Approximate Timelines
Measurement Requirements
This trial is evaluating whether Brief clinician education will improve 6 secondary outcomes and 18 other outcomes in patients with Bacteriuria. Measurement will happen over the course of 18 months.
Who is running the study
Principal InvestigatorPatient Q & A Section
What are common treatments for bacteriuria?
Bacteriuria often responds rapidly to one of many possible approaches. The choice of treatment and management depends mostly on previous experience with the condition in individual patients, and may vary depending on the type of infection (urinary, genital, perineal, etc.). Antibiotics should still be considered in cases of infection by bacteria that may contribute to urinary system or bony abnormalities. The effectiveness of topical antimetabolite drugs must be evaluated in randomized, controlled trials.
What is bacteriuria?
Of those with bacteriuria, almost one third were older than 60 years, while about one fifth were younger than 15 years. The most common sites were the urethra (30%), the prostate (25%), and the vagina (10%). The most common microorganism was Escherichia coli (13%) and Gram negative rods (8%). In older adults, however, gram positive organisms were more common.
What causes bacteriuria?
The main risk factors for bacteriuria in women who are not on hormonal contraception are previous history of urinary tract infection and previous pelvic inflammatory disease. These factors do not seem to influence the occurrence of bacteriuria during pregnancy or the postpartum period.
What are the signs of bacteriuria?
The risk of bacteriuria increases after 30 years of age. It increases with age and with obesity. When present, symptoms usually occur at the time of the onset of the signs.
Can bacteriuria be cured?
Patients that meet the NIH criteria to treat bacteriuria are unlikely to be cured with standard and current antibacterials. Only a few patients may benefit from treatment if present even when bacteriuria is not present. Further research is warranted to assess the risks and benefits of treating patients for bacteriuria.
How many people get bacteriuria a year in the United States?
About 13 million persons a year have bacteriuria, and the majority of them are at least 65 years old. The total costs of treatment and management for bacteriuria may be substantial. The occurrence of bacteriuria is increased in persons who are in nursing homes or those who have long-term bladder catheters. The increase in bacteriuria is higher in females than males.
Does ehr clinical decision support nudges improve quality of life for those with bacteriuria?
CDS use for urology consultations in a general practice reduces the need for a second consultation. Although the CDS did not improve the quality of life of patients in view of the positive response to the quality rating, the CDS did reduce waiting time for a second consultation.
Is ehr clinical decision support nudges typically used in combination with any other treatments?
The EHR will not be successful unless it is designed as an integrated and inclusive system which supports patient care. Its success cannot come at the expense of patients needing medical monitoring only. It should not be a substitute for such medical monitoring.
What is ehr clinical decision support nudges?
Findings from a recent study of this study indicate that PDAs outperformed PNs on a range of clinical decision points. The addition of CADN to PDAs provided an additional boost in their impact on clinical decision making.
What are the common side effects of ehr clinical decision support nudges?
There was extensive variation across different institutions in the common side effects of clinical decision support nudges when using real-world patient data. This may reflect the variation of the target population, but has also implications for the extent to which the results can be extended to other computerized systems. Moreover, the possibility to influence the rate of side effects using the decision support tool did not seem worthwhile. To increase the impact of decision support, we propose to add to the user interface not only the common side effects of clinical decision support but also the frequency of occurrence of the condition.
How serious can bacteriuria be?
The study population was aged 60 or over and 82% reported having the same or the same degree of urgency of urgency for treatment before the microbiological sampling and results on the day of sampling could be ascertained. The study has to be regarded as an uncontrolled pilot study and we can only describe it as such for the time being.
Does bacteriuria run in families?
Although bacteriuric families were identified at higher rates than the population-at-risk, the presence of bacteriuria in only the index case suggested that family or environmental factor other than maternal bacterial genotype was responsible for bacteriuria in one of at least 1/3 of families.