Optimizing Proton Pump Inhibitors (PPI) Prescribing With EHR-Based Decision Support

Not Applicable

Recruiting

• Conditions: Prescribing Patterns, Physician; Physician's Practice Patterns; Drug Utilization Review

• Registration Number: NCT06998966
• Lead Sponsor: University of California, Los Angeles

Brief Summary

The proposed study is a quality improvement initiative designed to rigorously evaluate new variations of UCLA Health's proton pump inhibitor (PPI) order panels, building on internal quality improvement efforts to optimize prescribing workflows within the Electronic Health Record (EHR). PPIs are notoriously overprescribed, and the study team has identified that the CareConnect default prescription setting of 90 days with three refills (360 pill days) exceed standard guidelines (in most cases, 60 pill days). It is unclear whether this is the most appropriate workflow. Given that deprescribing PPIs carries minimal risk for most patients, this initiative will assess whether modifying defaulted prescription lengths influences prescribing behavior while ensuring physicians retain full decision-making authority.

This evaluation of PPI order panel variations is embedded within UCLA's existing EHR system, ensuring that changes are tested pragmatically within routine workflows. The study aims to determine whether small adjustments to the order panel can better align prescribing patterns with clinical best practices while maintaining physician autonomy.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2025-05-21
• Study First Submitted QC: 2025-05-21
• Study First Posted: 2025-05-31
• Status Verified: 2025-06
• Last Update Submitted: 2025-06-05
• Last Update Posted: 2025-06-10
• Study Start: 2025-07
• Primary Completion: 2026-07
• Study Completion: 2026-09

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 372

Inclusion Criteria

• UCLA Health primary care physicians who have a clinical full-time equivalency of at least 25%.

Exclusion Criteria

• Physicians with a clinical full-time equivalency of less than 25%

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Inappropriate Pill Days	12 months	The study will take place within the existing UCLA Health Electronic Health Record (EHR) infrastructure. Data will be automatically collected from the EHR, focusing on pill days in excess of guidelines. The trial team will validate an eMeasure of inappropriate prescriptions as the primary outcome.

Secondary Outcome Measures

Name	Time	Method
Prescription Discontinuations	12 months	The study will take place within the existing UCLA Health EHR infrastructure. Data will be automatically collected from the EHR, focusing on prescriptions that have been discontinued for 90 days or more.
Prescription Refills	12 months	The study will take place within the existing UCLA Health EHR infrastructure. Data will be automatically collected from the EHR, focusing on prescriptions that are refilled.
Overall Average Pill Days	12 months	The study will take place within the existing UCLA Health EHR infrastructure. Data will be automatically collected from the EHR, focusing on pill days overall.
GI Bleeding Hospitalization	12 months	Balancing measure to ensure reducing PPIs does not lead to harm.

Trial Locations

Locations (1)

UCLA Health System; 🇺🇸 Los Angeles, California, United States