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:

* Outpatients aged 18 and over
* Met Criteria for Non-Psychotic Major Depressive Disorder
* Had a baseline HRSD-17 score of at least 14

Exclusion Criteria:

* Patients with a current Axis I diagnosis of somatization disorder, anorexia nervosa, bulimia, or obsessive-compulsive disorder
* Patients with current alcohol or substance dependence
* Women with a positive pregnancy test or who are lactating
* Women of child-bearing potential who are not practicing a clinically accepted method of contraception
* Patients with general medical conditions that contraindicate antidepressant medications
* Patient whose clinical status requires inpatient or day hospital treatment
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:

* All clinicians practicing at participating sites
* Parents with an eligible adolescent girl
* Adolescent girls
* Ages 11-17
* Has a visit at one of the primary care centers within the last 15 months.
* Has not completed the teen vaccine series

Exclusion Criteria:

* None
D: Inclusion Criteria:

* Patient eligibility:
* Current patients at community health center for routine visit
* 18 years or older
* Current or regular smoker (\>1 cigarette in past 7 days)
* Willingness to complete survey
* Provider eligibility:
* Provider at community health center
* 18 years or older
* Willingness to complete survey or interview

Answer: B