CLINICAL TRIAL

Brief clinician education for Bacteriuria

Waitlist Available · 18+ · All Sexes · Chicago, IL

This study is evaluating whether nudges can help reduce the overuse of tests and treatments in older adults.

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About the trial for Bacteriuria

Eligible Conditions
Type 2 Diabetes Mellitus · Prostate Specific Antigen Screening · Asymptomatic Bacteriuria · 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.

Main TreatmentA portion of participants receive this new treatment to see if it outperforms the control.
Brief clinician education
BEHAVIORAL
EHR clinical decision support nudges
BEHAVIORAL
Control TreatmentAnother portion of participants receive the standard treatment to act as a baseline.
Brief clinician education
BEHAVIORAL

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.

Inclusion & Exclusion Checklist
Mark “yes” if the following statements are true for you:
Northwestern Medicine primary care clinician who sees patients under department code of a randomized clinic
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Odds of Eligibility
Unknown<50%
Be sure to apply to 2-3 other trials, as you have a low likelihood of qualifying for this one.Apply To This Trial
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Approximate Timelines

Please note that timelines for treatment and screening will vary by patient
Screening: ~3 weeks
Treatment: varies
Reporting: 18 months and 19-24 months
Screening: ~3 weeks
Treatment: Varies
Reporting: 18 months and 19-24 months
This trial has approximate timelines as follows: 3 weeks for initial screening, variable treatment timelines, and reporting: 18 months and 19-24 months.
View detailed reporting requirements
Trial Expert
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- What options you have available- The pros & cons of this trial
- Whether you're likely to qualify- What the enrollment process looks like

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.

Diabetes overtreatment in the elderly by race
18 MONTHS
NIH-required analysis. Measure defined as having the most recent hemoglobin A1C during the measurement period of less than 7.0 and insulin or an oral hypoglycemic drug on their active medication list at the end of the measurement period among adults aged 75 years and older with a diagnosis of diabetes mellitus.
18 MONTHS
Diabetes overtreatment in the elderly by ethnicity
18 MONTHS
NIH-required analysis. Measure defined as having the most recent hemoglobin A1C during the measurement period of less than 7.0 and insulin or an oral hypoglycemic drug on their active medication list at the end of the measurement period among adults aged 75 years and older with a diagnosis of diabetes mellitus.
18 MONTHS
PSA screening in older men by ethnicity
18 MONTHS
NIH-required analysis. Measure defined as the presence of a PSA laboratory result in the EHR during the measurement period among men aged 76 years and older at the start of the measurement period with at least one visit during the measurement period with a primary care clinician and who are without a diagnosis or procedure suggesting a history of prostate cancer.
18 MONTHS
PSA screening in older men by race
18 MONTHS
NIH-required analysis. Measure defined as the presence of a PSA laboratory result in the EHR during the measurement period among men aged 76 years and older at the start of the measurement period with at least one visit during the measurement period with a primary care clinician and who are without a diagnosis or procedure suggesting a history of prostate cancer.
18 MONTHS
Rate of UTI requiring hospital care among women 65 and over following clinical decision support exposure
18 MONTHS
Emergency department visit or hospitalization for an infection originating from the urinary tract within 28 days of any primary care office visit with decision support exposure.
18 MONTHS
Rate of UTI requiring hospital care among women 65 and over following an office visit
18 MONTHS
Emergency department visit or hospitalization for an infection originating from the urinary tract within 28 days of any primary care office visit
18 MONTHS
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Who is running the study

Principal Investigator
S. P.
Prof. Stephen Persell,, MD
Northwestern University

Patient Q & A Section

Please Note: These questions and answers are submitted by anonymous patients, and have not been verified by our internal team.

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.

Anonymous Patient Answer

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.

Anonymous Patient Answer

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.

Anonymous Patient Answer

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.

Anonymous Patient Answer

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.

Anonymous Patient Answer

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.

Anonymous Patient Answer

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.

Anonymous Patient Answer

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.

Anonymous Patient Answer

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.

Anonymous Patient Answer

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.

Anonymous Patient Answer

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.

Anonymous Patient Answer

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.

Anonymous Patient Answer
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