An Emergency Department (ED) Provider Centered Intervention for Non-Traumatic Dental Condition Management (NTDC)

Not Applicable

Not yet recruiting

• Conditions: Odontalgia; Emergency Department Visit
• Interventions: Behavioral: Clinical decision support tool

• Registration Number: NCT06330207
• Lead Sponsor: University of Florida

Brief Summary

The overall objective of this proposal is to understand the barriers and facilitators to non-traumatic dental condition (NTDC) management in the emergency department (ED) through quantitative and qualitative methods. The first aim will determine the national variation in NTDC prescribing in the ED and subsequent ED/urgent care revisits and hospitalizations within 30-days of an index ED visit. Using national electronic health records and integrated claims datasets and a random effects model, we will identify factors associated with prescribing for NTDC and variation at the patient, provider, hospital and state levels. The second aim identifies ED providers' perceived barriers and facilitators to the management of NTDC in the ED. Using individual in depth interviews, ED providers (physicians, advanced practice providers) will identify the facilitators and barriers to management and prescribing for NTDC in the ED.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2024-02-15
• Study First Submitted QC: 2024-03-25
• Study First Posted: 2024-03-26
• Status Verified: 2025-04
• Last Update Submitted: 2025-04-21
• Last Update Posted: 2025-04-24
• Study Start: 2025-09-01
• Primary Completion: 2027-02-01
• Study Completion: 2027-08-01

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 60

Inclusion Criteria

• ED providers (physicians, nurse practitioners, physician assistants)
• Working full-time in the ED

Exclusion Criteria

• Part-time ED providers

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Intervention	Clinical decision support tool	ED providers who will test the clinical decision support tool when prescribing for patients with non traumatic dental conditions

Primary Outcome Measures

Name	Time	Method
Acceptability and feasibility	at baseline, and up to 6 months	Using qualitative methods, we will evaluate acceptability using the Theoretical Framework for Acceptability (TFA). Participants will complete a structured interview about acceptability at baseline and after 6 months of use, which should be sufficient time for providers to treat 5-10 patients for whom the tool is applicable. We pre-specify the criteria to define feasibility using criteria adapted from the NIH. Monthly during the trial, providers will answer feasibility surveys, using a web-based tool (i.e, RedCap) distributed via email. We will follow up with non-responders via text message, phone, or in-person. Providers will be offered a $5 gift card per survey as an incentive. To fully assess the impact of our intervention, we pre-specified a high retention rate as key to inform feasibility and effectiveness of future large-scale trials. We will consider successful implementation if \>50% of providers intend to continue using the NTDC CDST postpilot.

Secondary Outcome Measures

Name	Time	Method
Prescribing behavior	at baseline, and up to 6 months	For each participant, we will collect baseline antibiotic and opioid prescribing rates (per ED visit) for NTDC 6 months prior to the intervention from the EHR using the UPMC data analytics tool. All ED prescriptions in our system are created electronically, allowing precise capture of actual provider behavior. We will compare opioid and antibiotic prescribing for NTDC by providers before and after the intervention. To control for secular changes in prescribing, we will compare prescribing by participants during the same 6 months to prescribing by UPMC peers who did not receive the intervention.