Please select the eligibility criteria that correspond to the clinical trial below.
Title: A Mixed-method Study to Explore, Assess, and Explain the Translation of a Complex Set of Evidence-based Rules Into Practice Through Electronic Medical Record Based Decision Support: How Can STOPP Effectively be Deployed in Primary Care?
Brief Summary: This mixed methods study seeks to assess and understand the impact of using an advanced CDS tool to present the STOPP criteria to support prescribers at the point of decision-making. We ask the overarching question:

\*\*How can clinical decision support tools effectively translate a complex set of evidence-based rules into primary care clinical practice?\*\*

The work is divided into 2 phases.

PHASE 1: Randomized control trial. We will measure change in potentially inappropriate prescribing by primary care prescribers (e.g. family doctors) who are using the Clinical Decision Support (CDS) tool in their Electronic Medical Record (EMR), as compared to those who are not. Potentially Inappropriate Prescribing is defined by the STOPP criteria, the same criteria that will be used in the clinical decision support tool in the EMR. We will use the OSCAR EMR for this study. EMR based queries will be developed to assess the number of potentially inappropriate prescriptions are current in each of 12 physician practices at baseline and at 16 weeks.

PHASE 2: We will then complete a qualitative follow up with participants to aid in understanding how primary care prescribers perceived the CDS. This will help explain Phase 1 findings and provide additional information to enhance future decision support tools.


Options:
A: Inclusion Criteria:

* Have been using the OSCAR EMR v 12.x for \>12 months (to provide enough time for medications to be consistently documented in the EMR).
* Have OSCAR EMR installed locally in the practice.
* Agree to be or are already a part of the University of British Columbia's Department of Family Practice's (UBC DFP) research network.
* Ensure their OSCAR Service Provider (OSP) agrees to support the research network hardware/software installation.
* Have not used the STOPP criteria in OSCAR prior to the study.

Exclusion Criteria:

* Non-prescribers.
* Those who do not provide longitudinal care (e.g. walk-in clinics).
* Specialists or midwives.
* Those who do not have regular patients over age 64 (e.g. maternity clinics).
* Those who do not use OSCAR 12.1 or those that do not document prescriptions in their EMR prescription module.
* Those who have ALREADY used the STOPP rules in OSCAR prior to the study.
B: DISEASE CHARACTERISTICS:

* Receiving primary care at 1 of 11 participating Harvard Vanguard Medical Associates (HVMA) centers

  * Has an active primary care physician
  * Had a primary care visit within the past 18 months
* Is due for colorectal cancer screening

PATIENT CHARACTERISTICS:

* Not specified

PRIOR CONCURRENT THERAPY:

* Not specified
C: DISEASE CHARACTERISTICS:

* Primary care providers and their patients in the Brigham and Women's Primary Care Practice-Based Research Network
* Patient is currently a smoker

PATIENT CHARACTERISTICS:

* Must speak English or Spanish
* No significant cognitive impairment (e.g., dementia or active psychosis)

PRIOR CONCURRENT THERAPY:

* Not specified
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: A