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Open Access 01-12-2024 | Hyperkalemia | Study protocol

Can the integration of new rules into a clinical decision support system reduce the incidence of acute kidney injury and hyperkalemia among hospitalized older adults: a protocol for a stepped-wedge, cluster-randomized trial (DETECT-IP)

Authors: Anaïs Payen, Nour Elhouda Tlili, Etienne Cousein, Laurie Ferret, Antoine Le Bozec, Aurélie Lenglet, Romaric Marcilly, Pierre Pilven, Arnaud Potier, Chloé Rousselière, Julien Soula, Laurine Robert, Jean-Baptiste Beuscart

Published in: Trials | Issue 1/2024

Abstract

Background

Clinical decision support systems (CDSSs) enable the automated, real-time detection of situations associated with a risk of adverse drug events (ADEs). However, the effectiveness of CDSS in reducing ADEs has yet to be demonstrated. We have chosen to focus on the detection of ADE such as hyperkalemia and/or acute kidney injury (AKI), which are common among hospitalized older adults. The present study’s primary objective is to use a CDSS to reduce the number of ADEs (such as AKI and/or hyperkalemia) that occur in hospitalized older adults.

Methods

This is a multicenter, stepped-wedge, cluster-randomized study involving five hospitals. Each hospital will start with a control period (i.e., routine care, during which each center’s CDSS is deactivated) and then switch to an intervention period (during which the CDSS is activated). The intervention will be the use of a CDSS and a strategy for managing and transmitting alerts to clinical pharmacists. The rules concerning AKI and hyperkalemia have been drafted and reviewed by a multidisciplinary group. Each rule created in the CDSS is associated with a standardized procedure, based on a review of the literature. Older patients (aged 65 or over) admitted to a participating general medicine ward, a surgical ward, or obstetrics ward will be eligible for inclusion after the provision of verbal informed consent.

Discussion

This study will assess the effectiveness of the CDSS in reducing the incidence of AKI and hyperkalemia. The implementation of the CDSS can assist clinical pharmacists in their daily work and is expected to prevent ADEs.

Trial registration

ClinicalTrials.gov Identifier: NCT05923983. Registered February 02, 2023.

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Title: Can the integration of new rules into a clinical decision support system reduce the incidence of acute kidney injury and hyperkalemia among hospitalized older adults: a protocol for a stepped-wedge, cluster-randomized trial (DETECT-IP)
Authors: Anaïs Payen
Nour Elhouda Tlili
Etienne Cousein
Laurie Ferret
Antoine Le Bozec
Aurélie Lenglet
Romaric Marcilly
Pierre Pilven
Arnaud Potier
Chloé Rousselière
Julien Soula
Laurine Robert
Jean-Baptiste Beuscart
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: Hyperkalemia
Acute Kidney Injury
Acute Kidney Injury
Published in: Trials / Issue 1/2024
Electronic ISSN: 1745-6215
DOI: https://doi.org/10.1186/s13063-024-08569-w

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Can the integration of new rules into a clinical decision support system reduce the incidence of acute kidney injury and hyperkalemia among hospitalized older adults: a protocol for a stepped-wedge, cluster-randomized trial (DETECT-IP)

Abstract

Background

Methods

Discussion

Trial registration

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Abstract

Background

Methods

Discussion

Trial registration

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The effect of pre-emptive oral pregabalin on opioid consumption in patients undergoing laparoscopic sleeve gastrectomy with an analysis of intraoperative hemodynamic stability and quality of recovery: study protocol for a randomized, prospective, double-blind study

Does the use of higher versus lower oxygen concentration improve neurodevelopmental outcomes at 18–24 months in very low birthweight infants?

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