Effects of a Platelet Transfusion Best Practices Alert

NCT04155775 | Completed

• 1 other identifier: IRB-47797
• Study Type: interventional
• Target: 446
• Locations: 1 country
• Sites: 1

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).

Conditions

Thrombocytopenia

Keywords

Electronic Health Records; Best Practice Alerts

Outcome Measures

Primary Outcomes (1)

• Platelet transfusions above threshold

  Number of platelet transfusions occurring in patients with recent platelet counts above 50k/uL

  Data will be initially reviewed before 6 months from start with anticipated completion 1 year from start

Secondary Outcomes (1)

• Total platelet transfusions

  Data will be initially reviewed before 6 months from start with anticipated completion 1 year from start

Study Arms (2)

Best Practice Alert

EXPERIMENTAL

Platelet transfusion orders for patients with a recent platelet count exceeding 50,000 per microliter (50k/uL) will trigger an alert in the electronic health record that displays current guidelines for platelet transfusion. The alert will allow providers to bypass the recommendation and continue with platelet ordering by selecting a clinical acknowledgement / exception to recommendation.Exclusions will be built into the alert to avoid triggering in operative or procedural settings, for neurosurgery providers, or patients on anti-platelet medications.

Other: Computer electronic health record alert (Best Practice Alert - BPA)

No Best Practice Alert

NO INTERVENTION

For this group, no visible best practice alert will activate in the electronic health record for platelet transfusion orders and recent counts above 50k/uL.

Interventions

Computer electronic health record alert (Best Practice Alert - BPA) OTHER

Upon ordering platelets in patients with recent platelet count \>50,000, a pop-up within the electronic health system will recommend to not continue with transfuse product order and provide clinical exceptions to continue. Importantly, the alert does not trigger in operating areas, emergency medicine treatment areas, for certain specialties like neurosurgery or for massive transfusion orders.

Best Practice Alert

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

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

You may not qualify if:

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

Sponsors & Collaborators

• Stanford University: lead

Study Sites (1)

Stanford Healthcare

Stanford, California, 94305-5626, United States

Location

Related Publications (1)

• 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.

  PMID: 34081800 RESULT

MeSH Terms

Conditions

Thrombocytopenia

Condition Hierarchy (Ancestors)

Blood Platelet Disorders; Hematologic Diseases; Hemic and Lymphatic Diseases; Cytopenia

Study Officials

• Colin H Murphy, MD

  Stanford University

  PRINCIPAL INVESTIGATOR

• Neil Shah, MD

  Stanford University

  PRINCIPAL INVESTIGATOR

Study Design

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

Study Record Dates

• First Submitted: May 15, 2019
• First Posted: November 7, 2019
• Study Start: May 9, 2019
• Primary Completion: February 4, 2020
• Study Completion: February 4, 2020
• Last Updated: February 9, 2023

Record last verified: 2023-02

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)