Please select the eligibility criteria that correspond to the clinical trial below.
Title: Computer-Assisted Decision Support to Increase the Safety of Prescribing to Older Emergency Department Patients
Brief Summary: The subjects in this study are physicians working in the Wishard Emergency Department. The purpose of this study is to measure the extent to which information technology (i.e.-computers) improves emergency department care. The objective of our study is to evaluate the use of informatics in the emergency department and specifically to determine if computer reminder systems: 1) reduce the number of unsafe medications prescribed to older adults, 2) assist in more safely dosing of medications to adults of all ages, and 3) increase influenza immunization of eligible older patients in the emergency department.

Interventions: The interventions in this study are computer reminders. When releasing patients from the emergency department, physicians currently write all release orders, including prescriptions, on a computer order entry system that is linked to the Regenstrief Medical Record System. The computerized order entry system will be programmed so that physicians randomized (randomly placed) into the intervention group, the group that will receive the intervention, they will receive one of three types of reminders:

1. The medication prescribed is generally considered unsafe for use in older patients. The reminder will then list appropriate alternatives for this medication.
2. The dose of the prescribed medication is excessive and should be adjusted for the patient's creatinine clearance (or kidney function).
3. This patient may be eligible for influenza vaccination.

The physician will then choose to order or disregard the recommendation. The computer system will automatically record what the physician selected to do. The general outcome of interest is the extent to which the electronic reminders successfully improved physician practice in the emergency department setting. This outcome will be compared to physicians who were randomized to the group that did not receive the reminders (the control group).


Options:
A: Inclusion Criteria:

* Consecutive inpatients of the internal medicine and the orthopedic surgery department of the Cantonal Hospital of St. Gallen needing new onset oral anticoagulation

Exclusion Criteria:

* Patients with prior oral anticoagulation with coumarines within less than 6 weeks,
* patents, who received vitamin-K supplements within less than one week before the onset of oral anticoagulation,
* patients with liver cirrhosis other than Child A,
* pregnant women (pregnancy has to be excluded in women of childbearing age),
* patients younger than 18 years, and
* patients unwilling or unable to give informed consent
* patients with (clinically diagnosed) dementia and
* persons with insufficient German, French, Italian or English language skills)
B: Inclusion Criteria:

* The subjects of this study will be physician providers and residents and medical students practicing under the supervision of a faculty emergency physician. Specific study subjects will include emergency medicine faculty physicians; emergency medicine and internal medicine residents; emergency medicine, surgery, and internal medicine interns; and medical students taking care of patients in our emergency department.

Exclusion Criteria:

* We will not include the members of the research team in this study.
C: Inclusion Criteria:

* Dispensed one of 12 drugs or classes of drugs where baseline safety laboratory monitoring is recommended and labs have not been completed 6 months prior or 5 days after the dispense of the medication.
* 18 years of age or older
* 12-month HMO membership
* drug benefit coverage
* has telephone number

Exclusion Criteria:

* recommended baseline laboratory monitoring completed
* receives care and/or resides in hospice, nursing home, care outside HMO
* enrolled in other care management program
* nonEnglish speaking needing translation services
D: Inclusion Criteria:

* Physicians are eligible for inclusion if they are general practitioners or family physicians in full-time (≥ 4 days/week), fee-for-service practice in Quebec-patients where the study physician has written or dispensed psychotropic medications

Exclusion Criteria:

* under 65 years old

Answer: B