Reactive vs. Proactive Pain Control in IBD (PAIN-Sparing)
Reactive vs. Proactive Pain Control in Hospitalized Patients With Inflammatory Bowel Disease
The investigators will compare two physician behaviors for managing pain in patients with IBD: proactive vs. reactive. Both the proactive and reactive behavior/strategies are standard of care at the institution in which the study will be performed. The PROACTIVE strategy is an IBD-specific analgesic orderset (built into our EMR and approved by the institution's Pharmacy and Therapeutics committee), the REACTIVE strategy is a traditional "reactive" analgesic prescribing (prescribing medications only when patients have pain). The PROACTIVE IBD-specific analgesic orderset consists of medications which have evidence for use in IBD-related pain. This orderset is an educational guide, it does not force any order. The reactive prescribing habits could contain an array of pain medications depending on what the provider wants to prescribe.
Aims:
Aim 1: To assess whether there is a difference in pain scores or functional activity among hospitalized patients with IBD between reactive vs proactive physician behaviors.
Aim 2: To assess whether there is a difference in inpatient opioid-prescribing between reactive vs proactive physician behaviors.
Aim 3: To assess whether there is a difference in health care utilization, including length-of-stay and 30-day readmission, between reactive vs proactive physician behaviors.
Descripción general del estudio
Estado
Condiciones
Intervención / Tratamiento
Descripción detallada
Tipo de estudio
Inscripción (Actual)
Fase
- No aplica
Contactos y Ubicaciones
Ubicaciones de estudio
-
-
California
-
Los Angeles, California, Estados Unidos, 90048
- Cedars-Sinai Medical Center
-
-
Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Géneros elegibles para el estudio
Descripción
Inclusion Criteria:
- Adults with confirmed IBD diagnosis
- Admitted for primary IBD-related sign or symptom
Exclusion Criteria:
- Admitted for primary non-IBD complaint
- Surgery in the last 30 days
- Alternative (non-IBD) GI diagnosis determined
- Age <18
- Pregnancy
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Investigación de servicios de salud
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Doble
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
|---|---|
|
Experimental: Proactive
Proactive Analgesic Inpatient Narcotic-Sparing: Pain management in patients in the proactive physician-behavior group will be based on the IBD Pain orderset in our EMR. This orderset is already in use and standard-of-care at Cedars. The orderset uses pain medications, which have evidence for use in IBD. The orderset is simply a guide to clinicians and does not force any doctor or patient to be in a "protocol". |
Medications suggested to the physician with enhanced ease of ordering.
Otros nombres:
|
|
Sin intervención: Reactive (Control Group)
Pain management in patients in the reactive group (control group) will follow traditional prescribing habits.
As different providers vary in the way they treat pain, analgesic medication prescribing in the control group will be inherently variable in nature.
The control group does not constitute a lack of treatment or placebo; rather, pain management in the control group will not be proactive as in the intervention group.
|
¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
Patient-Reported Pain Scores
Periodo de tiempo: Difference in the average daily pain score from the first to the last day of hospitalization, typically 7 days.
|
Visual Analog Pain Numeric Rating Scale (Scale range 0 (no pain) to 10 (severe pain))
|
Difference in the average daily pain score from the first to the last day of hospitalization, typically 7 days.
|
Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
Healthcare Utilization
Periodo de tiempo: From hospital admission until hospital discharge, typically 7 days.
|
Hospital length of stay (in days)
|
From hospital admission until hospital discharge, typically 7 days.
|
|
Functional Activity
Periodo de tiempo: From hospital admission until hospital discharge, typically 7 days.
|
FitBit activity (number of steps per day)
|
From hospital admission until hospital discharge, typically 7 days.
|
|
Opioid-Consumption
Periodo de tiempo: From hospital admission until hospital discharge, typically 7 days.
|
Milligram morphine-equivalents consumed per day
|
From hospital admission until hospital discharge, typically 7 days.
|
Colaboradores e Investigadores
Patrocinador
Investigadores
- Director de estudio: Sameer K Berry, MD, MBA, Cedars-Sinai Medical Center
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio (Actual)
Finalización primaria (Actual)
Finalización del estudio (Actual)
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Actual)
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
- Enfermedades del Sistema Digestivo
- Enfermedades Gastrointestinales
- Gastroenteritis
- Enfermedades inflamatorias del intestino
- Enfermedad de Crohn
- Enfermedades intestinales
- Efectos fisiológicos de las drogas
- Depresores del sistema nervioso central
- Agentes del sistema nervioso periférico
- Agentes del sistema sensorial
- Analgésicos
- Estupefacientes
Otros números de identificación del estudio
- Pro00050742
Plan de datos de participantes individuales (IPD)
¿Planea compartir datos de participantes individuales (IPD)?
Información sobre medicamentos y dispositivos, documentos del estudio
Estudia un producto farmacéutico regulado por la FDA de EE. UU.
Estudia un producto de dispositivo regulado por la FDA de EE. UU.
Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .