Clinical trial NCT04155775: Effects of a Platelet Transfusion Best Practices Alert
Official title: Effects of a Platelet Transfusion Best Practices Alert
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Thrombocytopenia
Keywords: Electronic Health Records
Best Practice Alerts
Lead sponsor: Stanford University
Sponsor class: OTHER
First posted: 2019-11-07
Enrollment: 446
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: OTHER

Brief summary: This study is to determine the effectiveness of a computerized clinical decision support tool (Best Practice Alert - BPA) in reducing unnecessary platelet transfusions based on guidelines published by national transfusion societies such as the AABB (formerly American Association of Blood Banks).

Detailed description: A computerized alert will be deployed through the electronic health record. The alert will trigger when a provider orders platelet transfusion above a threshold supported by current guidelines. The alert will provide information on current evidence and give the provider the option to cancel the order or proceed. The alert will not be triggered in procedural areas such as the operating room or as part of any emergency orders to prevent any delays to urgent patient care.

The proposed project will evaluate this alert by randomizing its implementation by patient chart. The investigators will observe the prevalence of this alert and its impact on ordering practices for the next 3 months. For patient charts randomized not to receive the intervention, the providers will not receive any alerts, but the analytics tool will record if the alert would have been triggered and the pertinent clinical information. After a period of three months, the investigators will review patient and provider information through analytics tools, assessing differences in platelet usage between the patients whose charts showed the alerts vs. those (control) patient charts not showing alerts.

Eligibility criteria: Inclusion Criteria:

* Recent platelet count \>50k/uL
* Platelet transfusion ordered

Exclusion Criteria:

* Neurosurgery
* Procedure area (OR, catheterization lab, interventional radiology suite)
* Documented history of antiplatelet agent

Primary outcomes:
measure: Platelet transfusions above threshold
timeFrame: Data will be initially reviewed before 6 months from start with anticipated completion 1 year from start
Secondary outcomes:
measure: Total platelet transfusions
timeFrame: Data will be initially reviewed before 6 months from start with anticipated completion 1 year from start
Other outcomes:
Locations:
city: Stanford
country: United States
facility: Stanford Healthcare
state: California
Study officials:
affiliation: Stanford University
name: Colin H Murphy, MD
role: PRINCIPAL_INVESTIGATOR
affiliation: Stanford University
name: Neil Shah, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Murphy C, Mou E, Pang E, Shieh L, Hom J, Shah N. A randomized study of a best practice alert for platelet transfusions. Vox Sang. 2022 Jan;117(1):87-93. doi: 10.1111/vox.13132. Epub 2021 Jun 3.