EHR alerts help recruit patients for clinical trials

Clinical trial alerts (CTAs) generated by electronic health records are subject to alert fatigue, but remain helpful in potential recruitment of participants in clinical trials, according to a new study published in the Journal of the American Medical Informatics Association.

The researchers, from Ohio State University and the University of Cincinnati, analyzed 907 CTAs triggered by EHRs used by 178 physicians in a 36-week study. They found that the initial response rate by the physicians to the CTAs was about 50 percent. The response rate declined significantly over time, decreasing by 2.7 percent every two weeks. However, even after 36 weeks the response rate was still between 30 and 40 percent, not as low as anticipated.

"The use of EHR-based CTAs has been demonstrated to increase participant recruitment rates to clinical trials, and is a promising approach for overcoming the major problem of inadequate and slow participant recruitment," the researchers noted.

The researchers suggested that future CTA deployments be tailored to particular settings and frequencies to maximize their benefit and reduce alert fatigue.

Other research has pointed to the high frequency of reminders causing alert fatigue, rendering them ineffective. For example, a 2005 JAMIA study on drug alerts noted that physicians overrode alerts between 49 and 96 percent of the time. Another study, published in Health Affairs in December, indicated that EHR vendors purposely set alerts overly frequently to avoid liability. The researchers noted that response rates for clinical decision support tended to be lower than those for CTAs.

For more information:
- read the JAMIA CTA study
- here's the alert fatigue study from 2005
- check out the Health Affairs abstract

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