Evidence-based Laboratory Test Order Sets in Primary Care

Not Applicable

Completed

• Conditions: Diarrhea; Diabetes Mellitus; Anemia; Medication Monitoring; Gout; Fatigue; Chronic Kidney Diseases; Lung Embolism; Thyroid Diseases; Obesity
• Interventions: Other: CPOE with order sets for lab testing; Other: CPOE without order sets for lab testing

• Registration Number: NCT02950142
• Lead Sponsor: Universitaire Ziekenhuizen KU Leuven

Brief Summary

Cluster randomised controlled trial to evaluate what the effect is of evidence-based order sets aimed at five indications on the appropriateness of laboratory test ordering in primary care.

Detailed Description

Cluster randomised controlled trial in Belgian primary care practices. Participants will be primary care physicians working in primary care practices affiliated to one of three collaborating laboratories in the Leuven, Ghent or Antwerp regions.

Primary care practices will be allocated and randomized to either the intervention or control group. Physicians in PCPs randomized to the intervention will be offered order sets based on indication when using the CPOE for ordering laboratory tests. The effect of order sets will be analyzed for 17 common indications for ordering laboratory tests in Belgian primary care: diabetes mellitus, hypertension, cardiovascular disease, general check-up, unexplained fatigue, anemia, liver pathology, medication monitoring, gout, chronic kidney disease, lung embolism, acute coronary syndrome, diarrhea, thyroid disease, sexually transmitted disease, rheumatoid arthritis and obesity.

Study Timeline

• Study First Submitted: 2016-10-25
• Study First Submitted QC: 2016-10-27
• Study First Posted: 2016-10-31
• Study Start: 2017-12-01
• Primary Completion: 2018-06-01
• Study Completion: 2019-08-01
• Status Verified: 2020-01
• Last Update Submitted: 2020-01-17
• Last Update Posted: 2020-01-23

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 288

Inclusion Criteria

• Primary care practices will be considered eligible if all the physicians active in the practice agree to be involved in the study

• All family physicians will be considered eligible if they:

  • Collaborate with either MCH, Anacura or AML for their laboratory test orders
  • Agree to use the online CPOE for their laboratory test orders
  • Use a computerized EHR for patient care
  • Agree to the terms in the informed consent

Exclusion Criteria

• Primary care practices where one or more physicians refuse to be enrolled will be excluded

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
CPOE with order sets	CPOE with order sets for lab testing	Physicians who use CPOE including order sets for large range of indications.
CPOE without order sets	CPOE without order sets for lab testing	Physicians who use CPOE without order sets.

Primary Outcome Measures

Name	Time	Method
Appropriateness	3 months	number of appropriate tests for 17 study indications

Secondary Outcome Measures

Name	Time	Method
Missed or delayed diagnoses	1 year	Incidence of missed or delayed diagnoses after laboratory test
Laboratory test volume	1 year	Total volume of ordered laboratory tests

Trial Locations

Locations (1)

Academic Centre for General Practice; 🇧🇪 Leuven, Belgium