Improving Metoclopramide Prescribing Practices at Penn Through a Physician-targeted Intervention

Study Overview
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Brief Summary
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The investigators hypothesized that: 1) an intervention targeted at the prescribing physician would increase the rate of a metoclopramide discontinuation among patients prescribed the medication for questionable or unclear indications; and 2) the discontinuation would be durable.

Official Title
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Improving Metoclopramide Prescribing Practices at Penn Through a Physician-targeted Intervention

Conditions
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Gastroesophageal Reflux Disease, Diabetic Gastroparesis

Intervention / Treatment
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* Other: intervention letter


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Physicians at University of Pennsylvania Health System who ordered an active metoclopramide prescription with a questionable indication. Exclusion Criteria: Physicians-in-training (e.g., residents, fellows) Physicians how were investigators on this study Physicians serving on the the University of Pennsylvania Drug Use and Effects Committee or Information Technology Oversight Board
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: intervention<br>Physicians in the intervention group were mailed a written feedback letter regarding their patients who were prescribed questionable metoclopramide therapy. Non-intervention providers received no letter. The letter consisted of the following components: The name and medical record # of the patients involved Information regarding the metoclopramide prescription: dates, dosage, indication recorded, and the duration of therapy A reminder of the adverse effect of long-term metoclopramide therapy A recommendation to consider having the patient undergo a trial of metoclopramide discontinuation if appropriate, and documentation of a discussion of risk and benefits of metoclopramide therapy with patients A request that the physician document the discontinuation trial in the electronic medical record | Other: intervention letter<br>* Physicians in the intervention group were mailed a written feedback letter regarding their patients who were prescribed questionable metoclopramide therapy. Non-intervention providers received no letter. The letter consisted of the following components: The name and medical record # of the patients involved Information regarding the metoclopramide prescription: dates, dosage, indication recorded, and the duration of therapy A reminder of the adverse effect of long-term metoclopramide therapy A recommendation to consider having the patient undergo a trial of metoclopramide discontinuation if appropriate, and documentation of a discussion of risk and benefits of metoclopramide therapy with patients A request that the physician document the discontinuation trial in the electronic medical record<br>|
| No Intervention: non-intervention<br>No intervention letters were sent to subjects in this arm | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Discontinuation of metoclopramide therapy | Twelve weeks after the intervention period, we searched the medical records of patients in the intervention and non-intervention groups to determine whether discontinuation of metoclopramide therapy had taken place. | 12 weeks after intervention period | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Metoclopramide, Randomized Controlled Trial