NCT04310462

Brief Summary

Hydroxychloroquine (HCQ) is a disease-modifying, anti-rheumatic drug that regulates immune system activity and is typically prescribed to treat rheumatoid arthritis and systemic lupus erythematosus, as well as other immune conditions. Although generally well tolerated, study data have demonstrated that long-term use of HCQ may lead to irreversible and potentially vision-threatening retinal toxicity. The American Academy of Ophthalmology (AAO) issued guidelines in 2011, and again in 2016 that recommended dosing of HCQ be based on an individual's body weight, and also outlined how and when to screen for retinal toxicity. While clinicians have been aware of the potential side effects of HCQ for decades, studies have shown that many patients continue to receive higher than recommended doses. The goal of this study is to conduct a pragmatic trial to assess the utility of a new e-prescribing (eRX) interface for prescriptions of hydroxychloroquine (HCQ). The investigators will measure the effectiveness of the system in reducing the number of individuals prescribed HCQ over current guidelines by randomizing clinicians to the new interface. Ideally, the eRX interface will result in a lower number of potential adverse events (i.e. retinal toxicity) associated with high-dose, long-term use of HCQ.

Trial Health

57
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
65

participants targeted

Target at P50-P75 for not_applicable

Timeline
Completed

Started Feb 2017

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
terminated

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

February 1, 2017

Completed
3 years until next milestone

First Submitted

Initial submission to the registry

January 21, 2020

Completed
2 months until next milestone

First Posted

Study publicly available on registry

March 17, 2020

Completed
4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

February 28, 2024

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

February 28, 2024

Completed
Last Updated

September 19, 2024

Status Verified

September 1, 2024

Enrollment Period

7.1 years

First QC Date

January 21, 2020

Last Update Submit

September 9, 2024

Conditions

Outcome Measures

Primary Outcomes (6)

  • Prevalence of dosage above guidelines: 6.5 mg/kg (2011)

    Prevalence of dosage above 6.5 mg/kg

    Post intervention: 1 year

  • Prevalence of dosage above guidelines: 6.5 mg/kg (2011)

    Prevalence of dosage above 6.5 mg/kg

    Post intervention: 2 years

  • Prevalence of dosage above guidelines: 6.5 mg/kg (2011)

    Prevalence of dosage above 6.5 mg/kg

    Post intervention: 3 years

  • Prevalence of dosage above guidelines: 5.0 mg/kg (2016)

    Prevalence of dosage above 5.0 mg/kg

    Post intervention: 1 year

  • Prevalence of dosage above guidelines: 5.0 mg/kg (2016)

    Prevalence of dosage above 5.0 mg/kg

    Post intervention: 2 years

  • Prevalence of dosage above guidelines: 5.0 mg/kg (2016)

    Prevalence of dosage above 5.0 mg/kg

    Post intervention: 3 years

Study Arms (2)

New eRX Interface

EXPERIMENTAL

Providers assigned to the intervention arm will be presented with a new eRX interface upon writing new prescriptions for hydroxychloroquine in the EHR.

Other: New e-prescribing interface

Standard Interface

NO INTERVENTION

Providers assigned to the no intervention arm will be presented with the usual ordering interface when prescribing new prescriptions for hydroxychloroquine in the EHR.

Interventions

The goal of this study is to conduct a pragmatic trial to assess the utility of a new e-prescribing (eRX) interface for prescriptions of hydroxychloroquine (HCQ). Through randomization of clinicians to the new interface, the investigators will measure the effectiveness of the system in reducing the number of individuals prescribed HCQ over current guidelines.

New eRX Interface

Eligibility Criteria

AgeUp to 120 Years
Sexall
Healthy VolunteersYes
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

  • All providers that prescribed hydroxychloroquine in the year previous to the intervention start date in rheumatology and dermatology clinics

You may not qualify if:

  • Inactive providers in rheumatology and dermatology clinics

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

University of California, San Francisco

San Francisco, California, 94143, United States

Location

MeSH Terms

Conditions

Rheumatic Diseases

Condition Hierarchy (Ancestors)

Musculoskeletal DiseasesConnective Tissue DiseasesSkin and Connective Tissue Diseases

Study Officials

  • Jinoos Yazdany, MD

    University of California, San Francisco

    PRINCIPAL INVESTIGATOR

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

Study Record Dates

First Submitted

January 21, 2020

First Posted

March 17, 2020

Study Start

February 1, 2017

Primary Completion

February 28, 2024

Study Completion

February 28, 2024

Last Updated

September 19, 2024

Record last verified: 2024-09

Data Sharing

IPD Sharing
Will not share

Summary level data may be provided upon request

Locations