Choosing Tests Wisely in Rheumatology

NCT03240536 | Completed

• 1 other identifier: 109363
• Study Type: interventional
• Target: 638
• Locations: 1 country
• Sites: 1

Brief Summary

This is a randomized study intended to produce a reduction in ordering of inappropriate tests by general practitioners as determined by recommendations from the CRA's Choosing Wisely guidelines. This reduction of inappropriate testing is expected in referrals to the rheumatologists randomized to the intervention group. This study will further explore which recommendations from the Canadian Rheumatology Association (CRA)/Canada Choosing Wisely campaign have the most impact on regional referring physicians to the Rheumatology clinic at St. Joseph's Hospital, London.

Conditions

SLE

Keywords

Rheumatology Referral; Choosing Wisely

Outcome Measures

Primary Outcomes (1)

• Assessing the change in the number of the total number of ANA tests, back CT's and shoulder ultrasounds in rheumatology referrals

  -collecting the total number of ANA tests, back CT's and shoulder ultrasounds

  Change from baseline number of tests at year one, year two

Study Arms (2)

Intervention Group

EXPERIMENTAL

Ordering physicians who have referred to a rheumatologist in the St. Joseph's rheumatology clinic randomized to the intervention group will receive a brief Choosing Wisely form (for education of guidelines) faxed with the referral notice. At one and two years all ordering physicians will receive by fax a three question survey.

Other: Choosing Wisely form

Control Group

NO INTERVENTION

Ordering physicians who have referred to rheumatologists in the control group will not receive the Choosing Wisely form. At one and two years all ordering physicians will receive by fax a three question survey.

Interventions

Choosing Wisely form OTHER

The investigators will fax a "Choosing Wisely form" to ordering physicians that will include information from the Canadian Rheumatology Association Canada Choosing Wisely Guidelines. Three points will be included with some additional explanation of why these are important. The three guidelines included will be: 1. Don't order an ANA as a screening test in patients without specific signs or symptoms of systemic lupus erythematous (SLE) or another connective tissue disorder (CTD). 2. Don't routinely image patients with low back pain regardless of the duration of symptoms unless that are clinical reasons to suspect serious underlying pathology 3. Don' routinely order a shoulder ultrasound as it is likely to indicate a tear in many people over the age of 50 years and will not change the initial management.

Intervention Group

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Ordering physicians who recently made a referral to the Rheumatology clinic at St. Joseph's Health Care.

You may not qualify if:

• N/A, all recent referrals will be included.

Sponsors & Collaborators

• London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's: lead

Study Sites (1)

St. Joseph's Health Care London

London, Ontario, N6A4V2, Canada

Location

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Randomized Study

Study Record Dates

• First Submitted: July 27, 2017
• First Posted: August 7, 2017
• Study Start: May 15, 2018
• Primary Completion: September 8, 2021
• Study Completion: September 8, 2021
• Last Updated: April 26, 2022

Record last verified: 2022-04

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)