372 Participants Needed

Proton Pump Inhibitors for Acid Reflux

KC
Overseen ByKatelyn Clinical Research Coordinator
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: University of California, Los Angeles
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

Trial Summary

What is the purpose of this trial?

The proposed study is a quality improvement initiative designed to rigorously evaluate new variations of UCLA Health's proton pump inhibitor (PPI) order panels, building on internal quality improvement efforts to optimize prescribing workflows within the Electronic Health Record (EHR). PPIs are notoriously overprescribed, and the study team has identified that the CareConnect default prescription setting of 90 days with three refills (360 pill days) exceed standard guidelines (in most cases, 60 pill days). It is unclear whether this is the most appropriate workflow. Given that deprescribing PPIs carries minimal risk for most patients, this initiative will assess whether modifying defaulted prescription lengths influences prescribing behavior while ensuring physicians retain full decision-making authority.This evaluation of PPI order panel variations is embedded within UCLA's existing EHR system, ensuring that changes are tested pragmatically within routine workflows. The study aims to determine whether small adjustments to the order panel can better align prescribing patterns with clinical best practices while maintaining physician autonomy.

Eligibility Criteria

This trial is for healthcare providers at UCLA Health who prescribe proton pump inhibitors (PPIs) for conditions like acid reflux. The study aims to optimize PPI prescribing practices within the Electronic Health Record system.

Inclusion Criteria

UCLA Health primary care physicians who have a clinical full-time equivalency of at least 25%

Exclusion Criteria

Physicians with a clinical full-time equivalency of less than 25%

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Evaluation of new variations of PPI order panels within the EHR system to optimize prescribing workflows

12 months

Follow-up

Participants are monitored for safety and effectiveness after intervention, focusing on prescription discontinuations and GI bleeding hospitalizations

12 months

Treatment Details

Interventions

  • Proton Pump Inhibitors
Trial Overview The study tests new variations of PPI order panels in the EHR, specifically changing default prescription lengths from a standard of 90 days with three refills to shorter periods that align with clinical guidelines.
Participant Groups
3Treatment groups
Experimental Treatment
Active Control
Group I: Algorithmic Defaulting (Indication-Based Default)Experimental Treatment1 Intervention
The Electronic Health Record (EHR) automatically evaluates whether the patient at hand meets guideline criteria for long-term vs. short-term Proton Pump Inhibitors (PPI) use and it selects a default PPI prescription duration. (Providers can override the defaulted duration if they disagree with the automated assessment.) The order panel displays each PPI option below one of the following duration choices: For short-term PPI, this includes patients with conditions like Gastroesophageal reflux disease (GERD). For long-term PPI, this includes patients with conditions requiring extended therapy (e.g. Barrett's esophagus, chronic NSAID use)
Group II: Active Physician ChoiceExperimental Treatment1 Intervention
•The order panel displays each PPI option below one of the following duration choices: For short-term PPI, this includes patients with conditions like GERD. For long-term PPI, this includes patients with conditions requiring extended therapy (e.g. Barrett's esophagus, chronic NSAID use). The order panel removes the default selection, thus requiring providers to actively select a prescription duration for each patient, given the guideline education presented in the panel.
Group III: ControlActive Control1 Intervention
•Physicians use an unchanged prescribing workflow for Proton Pump Inhibitors (PPI) medications, with no changes to default dosage or duration.

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of California, Los Angeles

Lead Sponsor

Trials
1,594
Recruited
10,430,000+

National Institute on Aging (NIA)

Collaborator

Trials
1,841
Recruited
28,150,000+
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