Electronic health record nested pragmatic randomized controlled trial of a reminder system for serum lithium level monitoring in patients with mood disorder: KONOTORI study protocol
-
- Seki, Tomotsugu
- Department of Pharmacoepidemiology, Graduate School of Medicine/School of Public Health, Kyoto University
-
- Aki, Morio
- Department of Psychiatry, Toyooka Hospital
-
- Kawashima, Hirotsugu
- Department of Psychiatry, Toyooka Hospital・Department of Psychiatry, Kyoto University Hospital
-
- Miki, Tomotaka
- Department of Psychiatry, Toyooka Hospital・Department of Psychiatry, Kyoto University Hospital
-
- Tanaka, Shiro
- Department of Clinical Biostatistics, Graduate School of Medicine, Kyoto University
-
- Kawakami, Koji
- Department of Pharmacoepidemiology, Graduate School of Medicine/School of Public Health, Kyoto University
-
- Furukawa, Toshi A.
- Department of Health Promotion and Human Behavior, Graduate School of Medicine/School of Public Health, Kyoto University
Description
Background: The weaknesses of classical explanatory randomized controlled trials (RCTs) include limited generalizability, high cost, and time burden. Pragmatic RCTs nested within electronic health records (EHRs) can be useful to overcome such limitations. Serum lithium monitoring has often been underutilized in real-world practice in Japan. This trial aims to evaluate the effectiveness of the EHR-nested reminder system for serum lithium level monitoring in the maintenance of therapeutic lithium concentration and in the improvement of the quality of care for patients on lithium maintenance therapy. Methods: The Kyoto Toyooka nested controlled trial of reminders (KONOTORI trial) is an EHR-nested, parallel-group, superiority, stratified, permuted block-randomized controlled trial. Screening, random allocation, reminder output, and outcome collection will be conducted automatically by the EHR-nested trial program. Patients with a mood disorder taking lithium carbonate for maintenance therapy will be randomly allocated to the two-step reminder system for serum lithium monitoring or to usual care. The primary outcome is the achievement of therapeutic serum lithium concentration between 0.4 and 1.0 mEq/L at 18 months after informed consent. Discussion: The KONOTORI trial uses EHRs to enable the efficient conduct of a pragmatic trial of the reminder system for lithium monitoring. This may contribute to improved quality of care for patients on lithium maintenance therapy. Trial registration: University Hospital Medical Information Network (UMIN) Clinical Trials Registry, UMIN000033633. Registered on 3 July 2018.
Journal
-
- Trials
-
Trials 20 2019-12-11
Springer Nature
- Tweet
Keywords
Details 詳細情報について
-
- CRID
- 1050003824800721280
-
- NII Article ID
- 120006848249
-
- ISSN
- 17456215
-
- HANDLE
- 2433/251041
-
- Text Lang
- en
-
- Article Type
- journal article
-
- Data Source
-
- IRDB
- Crossref
- CiNii Articles
- KAKEN